A New Heavy Silicone Oil (HWS 46-3000) Used as a Prolonged Internal Tamponade Agent in Complicated Vitreoretinal Surgery (original) (raw)
Related papers
Long-Term Outcomes of Heavy Silicone Oil Tamponade for Complicated Retinal Detachment
European Journal of Ophthalmology, 2007
The surgical treatment of complicated retinal detachment with inferior retinal tears and proliferative vitreoretinopathy (PVR) is challenging. Silicone oil and long-acting intraocular gases, which are the most commonly used endotamponades in such cases, provide good support for the superior retina (1-3). However, due to their lower specific gravity than that of water, they leave a residual space in
Iranian Journal of …, 2009
Purpose: To evaluate the anatomical and functional outcomes of using heavy silicone oil as an internal tamponade for complicated cases of retinal detachment associated with proliferative vitreoretinopathy involving inferior retinal quadrants Methods: 55 eyes from 55 patients with complicated retinal detachments enrolled in this interventional case series study. All eyes underwent standard three-port pars plana vitrectomy with endolaser photocoagulation and heavy silicon oil injection. Patients were categorized in traumatic and nontraumatic groups based on underlying retinal pathology. Anatomical and functional outcomes as well as complications were evaluated during 14 months (mean follow-up was 10.3 months), postoperatively. Results: 55 patients, 11 women, and 44 men with a mean age of 37.18±24.2 years (from 4 to 104 years) underwent pars plane vitrectomy with heavy silicone oil injection. Mean preoperative logMAR visual acuity was 2.24 (±0.78) which significantly improved to 1.55 (±0.63) (P<0.005). Retinal redetachment occurred in 11 (20%) at early postoperative period (first month postoperatively) that was successfully managed by reoperations. Heavy silicone oil was removed in 39 (70%) patients after a mean of 5.8 months. Retinal reattachment was ultimately achieved in 37 (67.3%) patients after a mean of 2.3 operations per patient. Reattachment rates were significantly lower in traumatic (48%) compared to nontraumatic (83.3%) group (P=0.038). Intractable glaucoma, retinal redetachment due to proliferative vitreoretinopathy and band keratopathy were among the observed complications. Conclusion: Heavy silicon oil internal tamponade is a safe and effective therapeutic modality in complicated retinal detachments associated with pathologies affecting inferior retinal quadrants.
Heavy silicone oil as a long-term endotamponade agent for complicated retinal detachments
BioMed research international, 2014
We retrospectively evaluated a heavy silicone oil (HSO) as a long-term intraocular endotamponade agent to treat complicated RD by inferior PVR in 25 eyes of 25 patients. Patients underwent PPV and injection of Oxane HD as an internal tamponade agent. A comparison of preoperative and postoperative BCVA at month 1, month 6, and last visit was made in the group in which HSO was removed and in the group in which HSO was not removed. Statistical calculations were performed using the Wilcoxon test. The HSO was removed from 11 patients after a mean of 26.55 ± 21.38 months. The HSO remained inside the vitreous cavity in 14 eyes due to a high chance of PVR recurrence (mean follow-up period, 11.07 ± 7.44 months). Anatomic success was achieved in 92%. The BCVA in the group, in which HSO was not removed, improved significantly during the first 6 months. Among the patients who had the oil removed, there was improvement in BCVA after 1 month. Oil emulsification was the most common adverse effect ...
Novel Heavy Tamponade for Vitreoretinal Surgery
Investigative Ophthalmology & Visual Science, 2013
The aim of this study was to produce a heavy tamponade with a specific gravity greater than 1.06 g/mL that was optically transparent, could be manufactured using simple processing, could be injected using standard clinical equipment, and would have appropriate biocompatibility. METHODS. Aerosil silica was added to a phenyl trimethicone and mixed via a roller, overhead stirring, and ultrasonics. The refractive index, visible absorbance, and shear viscosity were measured. The injectability of the solutions was evaluated using the Accurus Viscous Fluid Injection system. The tamponade efficiency was assessed using a model eye chamber and compared with that of Densiron 68, Oxane HD, and F 6 H 8. The biocompatibility was evaluated in vitro and in vivo in rabbits. RESULTS. Tamponade agents were produced with specific gravities of 1.10, 1.11, 1.13, and 1.16 g/mL that had good optical clarity. Mixing using overhead stirring was sufficient to produce tamponade agents with shear viscosities in the range 1000 to 5000 mPaÁs that were reproducible and stable during storage. The solutions were easier to inject using the Accurus Viscous Fluid Injection system than silicone oil 1000 mPaÁs. The 11% silica solution had greater tamponade efficiency than Densiron 68 or Oxane HD. There was no evidence of cytotoxicity in vitro. Silica solution 11% induced cataract earlier than Polydimethylsiloxane 1000 (PDMS 1000). Silica solution 11% and phenyl trimethicone reduced the a-wave value at 1 week after vitrectomy, but recovery was observed at later time points. Silica solution 11% caused inner nuclear layer (INL) nuclei dropdown in inferior retina from 4 weeks postoperation. Polydimethylsiloxane 1000 induced a similar phenomenon in superior retina 12 weeks postoperation. CONCLUSIONS. We have produced a heavy tamponade with good clarity that has appropriate shear viscosity, injectibility, enhanced tamponade efficiency, and biocompatibility similar to that of PDMS 1000.
Acta Ophthalmologica, 2020
Silicone oil (SO) has been used as a long‐term tamponade agent in the treatment of complicated vitreoretinal diseases for about half a century, during which time many advances in surgical techniques and technologies have been made. This review summarizes the chemical and physical properties of SO, its indications and complications, including particularly emulsification. The mechanisms and risk factors for emulsification are discussed, as well as novel strategies for its effective removal. Finally, the review focuses on new improved formulations of SO, including research into slow‐release pharmacological agents within SO and provides an overview of alternatives to SO for the purpose of long‐term tamponade that are being developed.
Journal of Ophthalmology, 2014
Purpose. To evaluate the effectiveness and safety of perfluorohexyloctane (F6H8) for intraoperative flattening of the retina and of F6H8/silicone oil (SO) 1000 cSt as a postoperative tamponade for inferior retinal detachment with inferior proliferative vitreoretinopathy.Methods. This is a retrospective review of 22 patients who underwent pars plana vitrectomy using F6H8 as an intraoperative tool to flatten the retina. At the end of the surgery a direct partial exchange between F6H8 and SO 1000 cSt was performed, tamponing the eye with different ratios of F6H8/SO (70/30, 60/40, 50/50, 40/30, and 30/70). Anatomical and functional results and complications were evaluated over the follow-up period (mean 22.63 months).Results. F6H8 was efficacious for intraoperative flattening of the retina. Twenty-one of the 22 patients achieved a complete retinal reattachment. Postoperative visual acuity (VA) ranged from light perception to 20/70, with 72% of patients obtaining VA better than 20/400. N...
2021
Silicone oils are effective intraocular tamponade agents in the treatment of severe retinal detachments, because they maintain the adhesion between neurosensory retina and retinal pigment epithelium, thanks to their ability to remove aqueous humor from the surface of the retina. To understand their effectiveness, it is important to know the characteristics of silicone oils. Patients should be closely monitored due to many complications associated with intraocular silicon oil, such as inflammatory reaction, raised intraocular pressure, refraction disorders, cataract, and emulsification. This study presents corneal endothelial changes and some intraocular complications caused by silicone oil used as an intraocular tamponade agent in the case of vitrectomy for complex retinal detachments. The aim of the study was to demonstrate the damage of corneal endothelial cells after the use of silicone oil in patients with retinal detachment surgery. Endothelial specular microscopy measurements ...
Acta Ophthalmologica Scandinavica, 2007
Proliferative vitreoretinopathy (PVR) is the most important reason for blindness following retinal detachment. Presently, vitreous tamponades such as gas or silicone oil cannot contact the lower part of the retina. A heavier-than-water tamponade displaces the inflammatory and PVR-stimulating environment from the inferior area of the retina. The Heavy Silicone Oil versus Standard Silicone Oil Study (HSO Study) is designed to answer the question of whether a heavier-than-water tamponade improves the prognosis of eyes with PVR of the lower retina. Methods: The HSO Study is a multicentre, randomized, prospective controlled clinical trial comparing two endotamponades within a two-arm parallel group design. Patients with inferiorly and posteriorly located PVR are randomized to either heavy silicone oil or standard silicone oil as a tamponading agent. Three hundred and fifty consecutive patients are recruited per group. After intraoperative re-attachment, patients are randomized to either standard silicone oil (1000 cSt or 5000 cSt) or Densiron Ò as a tamponading agent. The main endpoint criteria are complete retinal attachment at 12 months and change of visual acuity (VA) 12 months postoperatively compared with the preoperative VA. Secondary endpoints include complete retinal attachment before endotamponade removal, quality of life analysis and the number of retina affecting re-operation within 1 year of follow-up. Results: The design and early recruitment phase of the study are described. Conclusions: The results of this study will uncover whether or not heavy silicone oil improves the prognosis of eyes with PVR.
Retina, 2013
Purpose: To evaluate the effectiveness and safety of the heavy silicone oil Densiron-68 as an internal retinal tamponade after vitrectomy in patients with primary inferior rhegmatogenous retinal detachment. Methods: A retrospective consecutive case series involving inferior rhegmatogenous retinal detachment in 42 patients recruited between 2007 and 2010 was completed. All patients underwent primary vitrectomy followed by injection of Densiron-68. Each patient was then examined at 1 week, 1 month, 3 months, and 6 months after its removal. Included patients had a rhegmatogenous retinal detachment with at least 1 retinal break between 4 and 8 clock hours and completed 6 months of follow-up after removal of Densiron-68. Assessments for reattachment of the retina, visual acuity, and any complications from the surgery were recorded. Results: Thirty-nine of 42 patients completed all follow-up visits. Anatomical success was achieved in 85% (33 of 39) of cases with one procedure, increasing to 95% (37 of 39) with additional surgery. The mean visual acuity improved from mean logarithm of the minimum angle of resolution of 1.29 ± 0.61 preoperatively to 0.87 ± 0.67 postoperatively. The most common complications were cataracts (83%, 10 of 12), posterior capsular opacification (22%, 6 of 27), and ocular hypertension (15%, 6 of 39). Conclusion: High anatomical success rates can be achieved with primary vitrectomy for inferior rhegmatogenous retinal detachment with the use of Densiron-68.