Artikel
Shifting of the PVR milieu after tamponade with heavy silicone oil
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Veröffentlicht: | 18. Juni 2008 |
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Background: While current data indicate that a heavier-than-water tamponade may successfully seal cases of complex inferior retinal re-detachments, where standard lighter-than-water procedures failed, there is recent evidence that the heavy endotamponade only shifts the risk of PVR to the upper part of the retina.
Methods: We analysed a total of 83 eyes which underwent autologous translocation of the choroid and RPE in ARMD. Intraoperative large defects of the retina and choroid result in a high risk of PVR. It can therefore be looked upon as a trauma/PVR model. 24 eyes had primary surgery with gas endotamponade (SF6 20%), 19 eyes with silicone oil (5000 mPAS) and 50 eyes with Densiron 68®.
Results: The rate of PVR was slightly higher compared to gas (7 out of 24 eyes; 29%), but no significant difference was found between the silicone oil (4 out of 19 eyes; 21%) and the Densiron 68® group (12 out of 50 eyes; 24%). Under silicone oil 5000 re-detachments occurred in the inferior retina. On the contrary, after heavy silicone oil PVR was seen in the upper retina.
Conclusions: In this study heavy silicone oil failed to prevent PVR, but instead shifted the PVR milieu from the lower part to the upper retina. There was no difference in the number of re-detachments under heavy silicone oil or regular silicone oil. For clinical practice a solution might be a planned sequential use of heavy silicone oil and conventional silicone oil/gas in the management of patients with high risk for PVR.