Heavy Silicone Oil (HSO) as endotamponade in Complicated Retinal Detachment (RD)

Abstract

Abstract: : Purpose: to evaluate the efficacy and safety of HSO as heavier than water retinal endotamponade in the treatment of complicated retinal detachment. Methods: New HSOs were used after pars plana vitrectomy to treat complicated RD. 29 eyes of 29 patients affected by recurrent RD for inferior tears and PVR (24), were semi–randomly injected with Oxane: Silicone Oil 5.700 csks–RMN3 mixture (viscosity 3.300 mPas, density 1,02 gr/cm3: 14eyes ) and Densiron 68 Silicone Oil 5000 csk–F6H8 (viscosity 1.400 mPas, density 1.06 gr/cm3: 15eyes). HSOs were injected as endotamponade at the end of the surgery. 12 o’clock iridectomy was performed in the aphakic patients (6 eyes). The mean duration of the endotamponade was 72 days (range 40–118). The HSOs were replaced with BSS, air, mixture air–gas or PDMS depending on retinal conditions. Main outcome measures were anatomic success and complications due to HSO. Follow–up ranged from 2 to 6 months. Results:After HSO removal HSO was exchanged with air (10 eyes), gas (15) or PDMS (4). 3 patients presented recurrent RD after the absorption of the gas. Retinal reattachment was achieved in 22 eyes at the end of the follow–up. HSOs were easily handled during the surgery. No intraoperative complications were observed. Postoperative complications were: HSO in the anterior chamber and pharmacologically controlled hypertonus in 1 eye, and epiretinal membranes in the upper sector causing DR recurrence in 4 cases. Densiron and Oxane apparently showed the same anatomic success and complications rate. Conclusions:These preliminary results show that HSOs can be used as an effective and safe endotamponade in the treatment of complicated RD. Complications are few and similar to those observed with conventional Silicone Oil, even if PVR occurred in the superior sector. In this study the behavior of the two HSOs used appeared comparable.

Keywords: retina • retinal detachment • vitreous substitutes