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D. Sandner, K. Engelmann, L.E. Pillunat; Results After Densiron® 68 Endotamponade in Complicated Retinal Detachments . Invest. Ophthalmol. Vis. Sci. 2005;46(13):5502.
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Purpose: Densiron® 68 a mixture of perfluorohexyloctane (F6H8) with standard silicone oil was used as a heavy silicone oil endotamponde in complicated inferior retinal detachments. The anatomic and functional outcome as intraocular adverse effects was evaluated after a three month endotamponade. Methods: Between 10/03 and 08/04 in 57 eyes (57 patients; mean age 65.5 years; 27 to 82 years) with persistent detachment in the inferior part of the retina a pars plana vitrectomy with heavy liquid oil endotamponade was performed. All eyes had a history of pervious vitreoretinal surgery (in average 2.05 operations). In 71% of the eyes an endotamponade with standard silicone oil (Oxane 5700®) was previous performed without successful anatomical reattachment. Results: Postoperatively, in average after 89.7 days (8 to 272 days) in 43 of the 57 eyes the Densiron endotamponade was removed. 20 eyes showed a complete retinal reattachment. In 21 eyes a re–surgery with standard silicone oil endotamponade due to a retinal redetachment after removal (n=11) or a persistent retinal detachment (n=10) under heavy silicone oil was necessary. Due to an ablatio non sanata in two eyes no further intervention was performed. The current retinal status of these 21 eyes delivered in 17 eyes a retinal reattachment and only in 4 eyes a persistent retina detachment with standard silicone oil. Regard to the functional outcome 14 eyes showed an improvement of visual acuity, 16 eyes were unchanged and 14 eyes lost at list two lines of vision. Severe intraocular adverse effects after removal of the Densiron intraocular tamponade weren’t observed. Less frequent a moderate temporary fibrin or inflammatory reaction, sterile hypopyon (n=6), vitreous hemorrhage/hyphema (n=4), temporary hypotonia (n=2) and secundary glaucoma, pseudohypopyon, Densiron droplets at the IOL–surface (resp. n=2) was seen. Conclusions: A heavy silicone oil endotamponade seems to be a promising new option in cases of complicated inferior retinal detachment. In contrast to former experiences with pure F6H8 only a mild to moderate anterior intraocular inflammation without membrane–like epiretinal formations were noticed. In particularly cases a re–surgery with standard silicone oil endotamponade as a second step procedure is necessary for a successful anatomical result . Redetachments after Dension removal appears predominantly in the upper circumference and has to taken in mind for surgical strategies.
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