Pars Plana Vitrectomy Alone for the Management of Inferior Breaks in Pseudophakic Retinal Detachment without Facedown Position

Martínez-Castillo, Vicente; Boixadera, Anna; Verdugo, Alicia; García‐Arumí, José

doi:10.1016/j.ophtha.2004.12.046

Cited by 106 publications

(89 citation statements)

References 23 publications

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“…Recently, tamponade of primary inferior RDs using intraocular gases 16,17 or even air 18,19 alone has been advocated with good functional and anatomical outcomes. Twelve out of our 40 identified cases had Densiron insertion for primary RD with inferior breaks and no PVR.…”

Section: Discussionmentioning

confidence: 99%

“…In the light of recent reports of successful functional outcomes for primary inferior RD repair using gases or air, [16][17][18][19] it would seem reasonable to reserve Densiron use for the more complex cases such as those with inferior PVR or trauma. Although Densiron fills a clinically important void in vitreous substitutution, further large-scale studies are necessary to determine the incidence of significant Densiron emulsification and its effects on clinical outcomes.…”

Section: Discussionmentioning

confidence: 99%

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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: 99%

Section: Discussionmentioning

confidence: 99%

Emulsification of Densiron-68 used in inferior retinal detachment surgery

Majid

Hussin

Biswas

et al. 2007

Eye

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“…Very good results have also recently been published with conventional silicone oil as a primary tamponade as well as a different method that uses only an air tamponade or avoids internal tamponades completely. 36,62 Currently, a multi-centre randomised trial is on its way comparing heavy silicone oil with conventional silicone oil in complicated RRD surgery. 54 It is to be hoped that the results of this trial will enable us to better define the current role of the next generation of heavy tamponades.…”

Section: Sticky Silicone Oil and Subretinal Tamponadementioning

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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“…We found a 95% primary success rate and in addition, our study was not restricted by the numbers of horseshoe tears present as was the case in the papers to which they refer. 2,3 Round or atrophic holes (included in the report by Martinez-Castillo et al 2 ) can be safely managed without the need for vitrectomy or internal tamponade with a 98% success rate 4 so that inclusion of these cases might be expected to result in a more favourable outcome. We did not refer to their smaller study as with only 15 cases, we considered the numbers insufficient for comparison.…”

mentioning

confidence: 99%

Scleral buckling combined with vitrectomy for the management of rhegmatogenous retinal detachment associated with inferior retinal breaks

Mokete

Williamson

2008

Eye

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Sir, Scleral buckling combined with vitrectomy for the management of rhegmatogenous retinal detachment associated with inferior retinal breaksWe commend Alexander et al 1 on their interesting paper and excellent results. However, information vital to the interpretation of the paper has been left out. This includes their definition of inferior retinal breaks, generally considered to be detachment from the 4 to 8 o'clock position. Variation in this definition would have a bearing on outcomes and our ability to compare with other series. Data in the paper on the number and distribution of retinal breaks are omitted. Comment would have been useful on lens status and visual acuity as well as information on proportions and decision algorithm used for buckling with a silicone sponge or encircling with a 240 band.A paper from our institution in 2001 2 stimulated interest in the management of inferior detachment by PPV alone, and since then, several papers have reported on this topic.3 Techniques and results have advanced since and there are two papers by Martinez-Castillo et al4,5 we feel should have been considered in the discussion. In pseudophakic rhegmatogenous detachment, they demonstrated, with pars plana vitrectomy, laser retinopexy, air, and no posture, 90% primary success. 4 In another pseudophakic series, they achieved 93.3% primary success 5 and they have more recently confirmed good results with their technique. Both rates are comparable to the figure reported in this paper, and as they were achieved without buckling, it raises the question of its influence (with attendant risks) on outcomes and take us back to previous findings of no difference between groups managed by either method. 3This is where the missing information would aid analysis.

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Pars Plana Vitrectomy Alone for the Management of Inferior Breaks in Pseudophakic Retinal Detachment without Facedown Position

Cited by 106 publications

References 23 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

Scleral buckling combined with vitrectomy for the management of rhegmatogenous retinal detachment associated with inferior retinal breaks

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