Interaction of Different Ocular Endotamponades as a Risk Factor for Silicone Oil Emulsification

Dresp, J.; Menz, Dirk–Henning

doi:10.1097/00006982-200510000-00014

Cited by 48 publications

(36 citation statements)

References 15 publications

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“…15 Interestingly, all 40 of our patients had perfluorodecaline intraoperative tamponade to assist retinal reattachment and direct perfluorodecaline to Densiron exchange. Infusion tubing was not changed and supplied Densiron glass syringes were used in all patients.…”

Section: Discussionmentioning

confidence: 87%

Emulsification of Densiron-68 used in inferior retinal detachment surgery

Majid

Hussin

Biswas

et al. 2007

Eye

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Purpose To report the clinical features of eight patients presenting with emulsification of the heavier than water vitreous substitute, Densiron-68. Methods Two patients underwent primary inferior retinal detachment (RD) surgery, two patients underwent giant retinal tear repair, three patients had repair of inferior RD complicated by proliferative vitreoretinopathy and one patient had inferior RD surgery following repair of a scleral rupture. All patients had insertion of Densiron-68. Results Significant emulsification of Densiron-68 was seen within 12 weeks of surgery in eight cases out of a total of 40 patients receiving Densiron-68. Conclusion Despite adequate Densiron fills, emulsification necessitated its removal. Emulsified Densiron may have contributed to significant intraocular inflammation, epiretinal membrane formation and cystoid macular oedema. Without removal, prolonged presence of emulsified Densiron may lead to keratopathy, secondary glaucoma and retinal toxicity secondary to partitioning of perfluorohexyloctane. This has potentially significant implications on the indications for Densiron-68 use and warrants consideration before deciding on the optimal surgical intervention for inferior RDs.

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Section: Discussionmentioning

confidence: 87%

Emulsification of Densiron-68 used in inferior retinal detachment surgery

Majid

Hussin

Biswas

et al. 2007

Eye

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“…55,56 In most series, an air-heavy tamponade exchange was the preferred method. 11,21,22,[32][33][34][35] If larger retinotomies are present, this might be complicated by slippage of the retinotomy edge; in such cases, a heavy liquid-heavy tamponade exchange can be performed, as an interface between the heavy liquid and the heavy tamponade becomes visible.…”

Section: Surgical Techniquesmentioning

confidence: 99%

“…However, interactions between heavy liquids and heavy tamponades might lead to a 'contamination' of the heavy tamponade, thereby increasing the risk for emulsification, 'sticky' silicone oil, and an inflammatory response. 27,55,56 Roider et al 14 routinely used a Ringer solution-heavy tamponade exchange, using the 'heavy liquid' effect of the heavy tamponades. Although no study has compared the different methods of heavy tamponade injection, an air-heavy tamponade exchange seems to be the recommended technique at present.…”

Section: Surgical Techniquesmentioning

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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“…Because the olefin RMN3 compound does not dissolve uniformly within the silicone oil, this allows the dispersion of small silicone oil droplets into the anterior chamber to form an ‘inverted pseudohypopyon’ [23]. Another possible explanation may be contamination with PFDL, resulting in reduced surface tension and instability of the silicone oil component of Oxane HD [22]. In the series of Majid et al [20], all eyes had direct exchange with PFDL intraoperatively, which may have contributed to the high incidence of significant emulsification.…”

Section: Discussionmentioning

confidence: 99%

“…In the event that direct exchange cannot be avoided, exchange should be performed in a manner that creates the least turbulence. This can be achieved with controlled and uniform oil flow, as well as close proximity of the oil infusion line to the heavy liquid surface [22]. …”

Section: Discussionmentioning

confidence: 99%

Oxane HD and Retinal Detachment Surgery in Routine Clinical Practice

Ang

Murphy²,

Ng³

et al. 2010

Ophthalmologica

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Background/Aims: To assess the outcomes and complications of endotamponade with Oxane HD following retinal detachment repair. Methods: Retrospective consecutive case series of inferior retinal detachment with Oxane HD endotamponade within a 3-year period. Results: Case notes for 18 eyes of 18 patients were reviewed. Four (22.2%) were total retinal detachments and 13 (72.2%) had proliferative vitreoretinopathy. The mean Oxane HD endotamponade and follow-up durations were 27 ± 38 and 66 ± 39 weeks, respectively. The eventual anatomic success rate was 77.8%, but without any significant difference in vision. Postoperative complications occurred in 14 (77.8%), including emulsification (6 eyes; 33.3%), epiretinal membrane (5 eyes; 27.8%), and posterior capsular opacification (4 eyes; 22.2%). Of the 14 eyes requiring intraoperative perfluorodecalin, 12 (85.7%) developed complications; all 5 (100%) eyes with direct exchange of perfluorodecalin with Oxane HD developed complications. Conclusion: Although useful for inferior retinal detachments, Oxane HD was associated with a relatively high rate of emulsification when compared to other series. Our series also suggests that prior use of perfluorodecalin intraoperatively, and in particular direct exchange of perfluorodecalin with Oxane HD, may be associated with an increased risk of intraocular complications.

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Interaction of Different Ocular Endotamponades as a Risk Factor for Silicone Oil Emulsification

Cited by 48 publications

References 15 publications

Emulsification of Densiron-68 used in inferior retinal detachment surgery

Emulsification of Densiron-68 used in inferior retinal detachment surgery

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

Oxane HD and Retinal Detachment Surgery in Routine Clinical Practice

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