Abstract

SO.07.02

Primary vitrectomy with Densiron 68^® heavy silicone oil as long-term endotamponade

Heimann H., Stappler T., Wong D.
Royal Liverpool University Hospital

Objective: To evaluate the safety and efficacy of Densiron 68^® in primary vitrectomy for complicated cases with inferior retinal pathology.
Methods: We present a prospective, interventional non-comparative case series of 45 eyes of 45 consecutive patients recruited from January 2004 till August 2006. Primary vitrectomy and heavy silicone oil was used in all cases. The primary end point was anatomical re-attachment of the retina. Cases were judged successful when there was reattachment of the retina in the absence of any tamponade agent. The secondary end point was to record the visual function and any complications arising from surgery. The inclusion criteria consisted of proliferative vitreoretinopathy (PVR), retinal detachments (RD) arising from posterior or inferior retinal breaks; and an inability of the patient to posture. In the presence of PVR, patients with superior and inferior breaks were included. Protocol consisted of a minimum of eight clinic visits: baseline, HSO-surgery, 1 week, 1month post HSO, removal of oil and 1 week, 1 month and 3 months postoperatively.
Results: Characteristics of the patient population were 58.9 years (±16.7), (m:f=23:22), (R:L=26:19). Indications were inferior retinal breaks in 34 (75%, range:1–6 breaks) of cases, PVR was present in 23 (51%), there were 3 cases of trauma and 3 RPE-patch grafts. The extent of the detachments was 2.09 quadrants (±1.13) with macular involvement in 23 cases (51.1%). 75% of the retinal breaks were inferior to 10-2 o’clock, the majority being at 6 o’clock.
The primary re-attachment rate was 36 (80%) and the final re-attachment rate was 91%. One patient was lost to follow-up and one patient had a peripheral taut retina with good vision not requiring treatment. Visual Acuity rose from 1.15 LogMar (±0.94) to 0.62 (±0.53)(p=0.002). Densiron was removed after 140 days (±39; range 46-228).
Conclusions: In the absence of an “ideal” tamponade agent that can provide simultaneous support for the superior as well as the inferior retina, a tamponade agent that “sinks” is a welcome new tool at the surgeon’s disposal.

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