Abstract
Abstract: :
Purpose: To analyze the clinical efficacy, safety, and possible complications of internal tamponade with a mixed "heavy" substance (Densiron 68®) consisting of 70 % silicone and 30 % perfluorohexyloctane. Methods: Between 1.1.2004 and 15.8.2004 Densiron 68® was applied in 20 eyes (20 patients, 12 male, 8 female, median age: 62 years, range: 28–85) with major retinal complications (traction, breaks) in the lower quadrants. 14 of 20 had been subject to one or two major unsuccessful retinal/vitreoretinal interventions previously. Densiron 68® internal tamponade was applied for a median duration of 62 days (range: 35–104 days, one drop out case). Median follow–up period was 5 months (range: 3 – 12 months). Results: Complete retinal reattachment was primarily achieved in 20/20 eyes. During the period of Densiron 68®–internal tamponade partial tractional retinal redetachment occurred in 5/20 eyes and in 2/20 eyes after Densiron 68® removal. Secondary PVR during Densiron 68® endotamponade was always relatively limited. Retinal status at the end of follow–up was: complete attachment 17/20 eyes (85 %), and partial peripheral detachment 3/20 (15%). The following complications associated to the use of Densiron 68® were observed: minor posterior segment dispersion 6/20, deposition of small dispersive volumes in the anterior chamber angle 10/20 eyes (6/10 phakic). One of these eyes developed significant inferior chamber angle synechiae and chronic elevation of IOP. Pigmented deposits or fine posterior capsule membrane formation were observed in 8/20 eyes, "fluffy pigmented material" was found in one eye. In one eye a transient pseudoendophthalmic inflammatory reaction (culture negative) was observed. Removal of Densiron 68® was uneventful without significant retinal adhesion. In 4/19 eyes Densiron 68® presented a sticky posterior lens capsule (2 phakic eyes) or posterior IOL surface (2 eyes) adhesion. Conclusions: According to our preliminary experience Densiron 68® seems to be an effective and safe new heavy internal tamponade substance. Use of Densiron 68® was associated with a relatively low rate and a minor expression of secondary posterior segment proliferations. Small volume dispersions are frequently observed in 6 o'clock position of the anterior chamber angle. These microdispersions should be removed since they may be related to trabecular obstruction.
Keywords: vitreoretinal surgery • vitreous substitutes • retinal detachment