Anatomical and functional outcomes after heavy silicone oil tamponade in vitreoretinal surgery for complicated retinal detachment: a pilot study

Ophthalmology. 2005 Sep;112(9):1574. doi: 10.1016/j.ophtha.2005.04.013.

Abstract

Purpose: To evaluate the effectiveness and safety of a heavy silicone oil (HSO) tamponade for complicated retinal detachment (RD) surgery.

Design: Prospective consecutive interventional case series study.

Participants: The study included 26 patients with RD complicated by severe proliferative vitreoretinopathy (PVR) in the inferior quadrants.

Methods: All patients underwent pars plana vitrectomy with an internal tamponade using HSO. This tamponade was obtained by mixing 30% by volume perfluorohexyloctane and 70% by volume silicone oil, 1000 millipascal-seconds (polydimethylsiloxane 1000).

Main outcomes measures: Anatomical and functional results and complications at 1 year of follow-up.

Results: Twenty-four of 26 patients achieved anatomical success, defined as complete retinal reattachment. Postoperative visual acuity (VA) values ranged from hand movements to 20/25, with 69.2% of patients obtaining VA better than 20/400. Postoperative complications included early postoperative ocular hypertension in 30.7% of cases, which was easily controlled. Dispersion was noted in 1 case and was not felt to be significant. A cataract requiring surgical removal developed in 2 cases, and an after cataract developed in 3 cases.

Conclusions: In this pilot study, the HSO tamponade obtained by mixing 30% perfluorohexyloctane and 70% polydimethylsiloxane 1000 was associated with a high rate of anatomical success after vitrectomy in cases of RD complicated by severe PVR (greater than CP-6 and greater than CA-6 [updated Retina Society PVR classification]).

Publication types

  • Clinical Trial

MeSH terms

  • Aged
  • Aged, 80 and over
  • Dimethylpolysiloxanes / therapeutic use*
  • Drug Therapy, Combination
  • Female
  • Fluorocarbons / therapeutic use*
  • Humans
  • Male
  • Middle Aged
  • Pilot Projects
  • Postoperative Complications
  • Prospective Studies
  • Retina / anatomy & histology*
  • Retinal Detachment / etiology
  • Retinal Detachment / surgery*
  • Safety
  • Silicones / therapeutic use*
  • Treatment Outcome
  • Visual Acuity / physiology*
  • Vitrectomy / methods
  • Vitreoretinopathy, Proliferative / complications
  • Vitreoretinopathy, Proliferative / surgery*

Substances

  • Dimethylpolysiloxanes
  • Fluorocarbons
  • Silicones
  • baysilon
  • perfluorohexyl-octan