Contact angles of substances used for internal tamponade in retinal detachment surgery

Fawcett, I. M.; Williams, Rachel; Wong, David

doi:10.1007/bf00186587

Cited by 97 publications

(106 citation statements)

References 17 publications

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“…In fact, in an experimental eye model, an 80% fill with SO would guarantee only a 1808 angle of tamponade. 22 Consequently, the SO bubble, leaving a portion of the detached retina uncovered, may favor a more gradual and slow reabsorption of the subretinal fluid in comparison to gas, especially if the filling is not perfect. This would give the detached and stretched retinal surface time to decrease and to smoothly match its original location.…”

Section: Discussionmentioning

confidence: 99%

Incidence and Factors Influencing Retinal Displacement in Eyes Treated for Rhegmatogenous Retinal Detachment With Vitrectomy and Gas or Silicone Oil

dell’Omo

Scupola

Viggiano

et al. 2017

Invest. Ophthalmol. Vis. Sci.

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PURPOSE. The purpose of this study was to study the incidence and factors influencing retinal displacement in eyes treated for rhegmatogenous retinal detachment (RRD) with pars plana vitrectomy (PPV) and gas or silicone oil.METHODS. This was a prospective observational case series. One hundred twenty-five eyes with macula-off RRD from 125 patients underwent 25-gauge PPV at two vitreoretinal institutional practices. Eyes without proliferative vitreoretinopathy (PVR) or PVR grade A were tamponated with sulfur hexafluoride (SF6) gas, whereas eyes with PVR grade B received 1000 centistokes silicone oil (SO). The patients postured face-down immediately after surgery. Blue-fundus autofluorescence (B-FAF) pictures were obtained at each follow-up examination. Main outcome measures were incidence and direction of retinal displacement.RESULTS. Ninety-seven eyes (77.6%) were tamponated with SF6 and 28 eyes (22.4%) with SO. After retinal reattachment, displacement was observed in 44 of 125 (35.2%) eyes (40 eyes in the SF6 group and 4 eyes in the SO group, respectively). The type of tamponade, specifically gas, was the only significant predictor of retinal displacement (P ¼ 0.007). The displacement was downward in 39 (88.6%) eyes (36 tamponated with SF6 and 3 with SO) and upward in 5 (11.4%) eyes (4 tamponated with SF6 and 1 with SO).CONCLUSIONS. Displacement of the retina after repair of macula-off RRD with PPV is observed using either SF6 gas or SO. Downward and upward displacements may occur with both tamponades, but downward dislocation is more common. Of the factors potentially implicated in favoring displacement that were studied, only the type of tamponade, specifically the gas, was significant.Keywords: blue fundus autofluorescence, retinal vessel printings, retinal detachment, pars plana vitrectomy, retinal displacement T here has recently been a trend toward pars plana vitrectomy (PPV) as the preferred method for treatment for rhegmatogenous retinal detachment (RRD). The reasons behind this trend include the advent of outpatient ambulatory surgery and improvements in technology, instrumentation, and viewing systems. [1][2][3][4][5] When PPV is chosen for the treatment of RRD, it is typically accompanied with a postoperative intraocular tamponade agent-most commonly gases or silicone oils (SOs). Many surgeons prefer to use SO for complicated RRD or if postoperative airplane or high elevation travel is planned. However, a recent prospective study has shown that PPV with SO injection is also a safe and efficient surgical approach for treatment of primary uncomplicated RRD. 6 The use of both gas and SO in conjunction with PPV for repair of RRD may be associated with unintentional displacement of the retina. [7][8][9][10][11][12] Blue fundus autofluorescence (B-FAF) elegantly depicts this shift via lines of increased autofluorescence, which closely reflect the caliber and orientation of the adjacent retinal vessels. These lines indicate the original location of the retinal vessels, which have been displaced along with t...

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Section: Discussionmentioning

confidence: 99%

Incidence and Factors Influencing Retinal Displacement in Eyes Treated for Rhegmatogenous Retinal Detachment With Vitrectomy and Gas or Silicone Oil

dell’Omo

Scupola

Viggiano

et al. 2017

Invest. Ophthalmol. Vis. Sci.

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“…5 In a series of model eye experiments, we demonstrated that their ability to displace aqueous from the surface of the retina is poor as compared to gas such that a slight under-fill with silicone might leave large areas of the retina unsupported. 6 Others have made the same point that for silicone oil to be effective, it needs to fill the vitreous cavity 100%.…”

Section: Introductionmentioning

confidence: 98%

Heavy tamponade 2 Densiron 68® in routine clinical practice: anatomical and functional outcomes of a consecutive case series

Stappler

Heimann

Wong

et al. 2008

Eye

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Purpose To evaluate the safety and efficacy of Densiron 68 s in the clinical management of complex vitreoretinal cases with inferior retinal pathology. Methods We present a prospective interventional non-comparative case series of 122 eyes of 121 consecutive patients. The primary end point was anatomical reattachment of the retina, defined as retinal reattachment in the absence of any tamponade agent. The secondary end point was to record the visual function and surgical complications. Inclusion criteria were proliferative vitreoretinopathy, posterior or inferior retinal breaks, and the patient's inability to posture. Results Patients were 59.9 years ( ± 19.6), (m/f ¼ 72:49), (R/L ¼ 65:57). Seventy-seven (63.1%) had previous unsuccessful retinal surgery and 45 had Densiron 68 at first procedure. The extent of the detachments was 2.21 quadrants ( ± 1.07) with macular involvement in 66 cases (54%). Eighty-seven (71.3%) patients achieved retinal re-attachment with one retinal operation and ultimately no tamponade, 102 (83.6%) achieved retinal reattachment with more than one operation and ultimately no tamponade, and 112 (91.3%) patients achieved flat retina with tamponade in situ. Visual acuity rose from 1.38 LogMar ( ± 0.87) to 1.06 ( ± 0.83) (P ¼ 0.007). Densiron was removed after 135 days ( ± 73.2; range 35-405) Conclusion No tamponade agent can provide simultaneous support for the superior as well as the inferior retina; therefore, a tamponade agent that 'sinks' is a welcome new tool at the surgeon's disposal. The sequential use of heavy silicone oil followed by conventional silicone oil may be an acceptable management strategy in recurrent detachment.

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“…Our model eye chamber showed that it is difficult to achieve a 100% fill simply because the cavity is rounded. 31 …”

Section: Introductionmentioning

confidence: 99%

Heavy tamponade 1: a review of indications, use, and complications

Heimann

Stappler

Wong

2008

Eye

117

125

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Background Heavier than water intraocular tamponades have several theoretical advantages over conventional tamponades, especially in the treatment of complicated retinal detachments and proliferative viteroretinopathy of the lower fundus periphery. However, initial clinical series of various heavy tamponades have reported significant complication rates. Therefore, heavy tamponades have not found widespread acceptance. Three recently developed heavy silicone oil tamponades, Oxane HD, Densiron 68, and HWS 46-3000, are much better tolerated and presently seem to enter routine clinical practice. Materials and methods Literature review of 21 publications on the clinical application of 9 different heavy tamponades (fluorosilicone, C10F18, F6H8, OL62HV, Oxane HD, O62, F6H8-silicone oil mixture, Densiron 68, and HWS 46-3000). Results The first generation (fluorinated silicone and perfluorocarbon liquids) and second generation (partially fluorinated alkanes) of heavy tamponades were associated with relatively high complication rates, for example, tamponade emulsification, intraocular inflammation, and rise in intraocular pressure. The complication spectrum of the new generation of heavy silicone oils (Oxane HD, Densiron 68, and HWS 46-3000) seems to be comparable to conventional silicone oil tamponades while providing better support for the inferior retina and the posterior pole. Conclusion The recently developed heavy silicone oil tamponades are safe and effective tools for the use of complicated retinal detachments of the inferior fundus.

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Contact angles of substances used for internal tamponade in retinal detachment surgery

Cited by 97 publications

References 17 publications

Incidence and Factors Influencing Retinal Displacement in Eyes Treated for Rhegmatogenous Retinal Detachment With Vitrectomy and Gas or Silicone Oil

Incidence and Factors Influencing Retinal Displacement in Eyes Treated for Rhegmatogenous Retinal Detachment With Vitrectomy and Gas or Silicone Oil

Heavy tamponade 2 Densiron 68® in routine clinical practice: anatomical and functional outcomes of a consecutive case series

Heavy tamponade 1: a review of indications, use, and complications

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