Vitrectomy with scleral buckling versus with inferior retinectomy in treating primary rhegmatogenous retinal detachment with PVR and inferior breaks

Eleinen, Khaled G Abu; Mohalhal, Ahmed A.; Ghalwash, Dalia A.; Abdelkader, Ahmed; Ghalwash, Ahmed; Mohalhal, Islam A.; Abdullatif, Abdussalam M

doi:10.1038/s41433-018-0194-0

Cited by 12 publications

(4 citation statements)

References 28 publications

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“…One of the reasons for a lower success rate in these cases is the lack of inferior retinal support with the traditional endotamponade agents, including sulfur hexafluoride (SF6), octafluoropropane (C3F8), or silicone oil, which require more challenging patient posturing after surgery. 1,2 Other surgical approaches for inferior detachments include scleral buckle, combined vitrectomy and scleral buckle, and inferior retinectomy with or without the use of silicone oil. 3 Heavy silicone oils (HSOs), and specifically Densiron 68 (FLUORON GmbH, Neu-Ulm, Germany) with a density of 1.06 g/cm 3 and a viscosity of 1,400 mPas, provide support to the inferior retina and may serve as a good alternative.…”

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confidence: 99%

Densiron 68 Heavy Silicone Oil as a Short-Term Intraocular Tamponade for Macula-on Inferior Retinal Detachments—a Case Series

Hostovsky

Yap

Mandelcorn

et al. 2022

RETINAL Cases &Amp; Brief Reports

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Purpose: To describe our experience using short-term heavy silicone oil (Densiron 68) for macula-on inferior rhegmatogenous retinal detachments with inferior retinal breaks.Methods: Retrospective, consecutive, observational case series. Data were retrospectively collected from the medical records of patients who underwent pars plana vitrectomy and Densiron 68 endotamponade for macula-on rhegmatogenous retinal detachment repair.Results: Eight patients were included in the study. The mean patient age was 57.1 ± 12.3 (±SD) years. The mean time to Densiron 68 removal was 57.8 ± 17.8 (±SD) days (ranging from 24 to 83 days). One patient (12.5%) detached three weeks after Densiron 68 removal and required further surgery. All patients were attached at last follow-up with a mean follow-up of 192 days. The mean final best-corrected visual acuity was 20 of 40 (0.29 logarithm of the minimum angle of resolution) similar to the 20 of 45 preoperative bestcorrected visual acuity (0.35 logarithm of the minimum angle of resolution, P = 0.501). No significant emulsification was noted before or during the removal of the Densiron 68. Two patients developed an increase in intraocular pressure before Densiron 68 removal that resolved after removal. One patient developed cystoid macular edema that resolved with a short course of topical medications, and one patient had persistent CME that required an intravitreal triamcinolone acetate 1% injection. Conclusion:The high anatomic success rate, good visual outcomes, and minimal complications suggest that Densiron 68 can be considered as a short-term tamponade for macula-on retinal detachments with inferior pathology.

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confidence: 99%

Densiron 68 Heavy Silicone Oil as a Short-Term Intraocular Tamponade for Macula-on Inferior Retinal Detachments—a Case Series

Hostovsky

Yap

Mandelcorn

et al. 2022

RETINAL Cases &Amp; Brief Reports

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“…Moreover, Ghoraba et al [37] have demonstrated that the use of ESB in combination with PPV and SO offered no additional effect on either the anatomical success or the rate of macular hole closure in the management of myopic macular hole RD. Eleinen et al [38] described similar anatomical and functional outcomes by combining PPV with ESB or inferior retinectomy for the treatment of primary RRD with PVR and inferior breaks. A recent study by Rossi et al [39] using an elegant in vivo model has demonstrated that 360° scleral indentation did not improve SO-retinal contact and that it promotes a significant shear stress increase at the indentation site.…”

Section: Discussionmentioning

confidence: 99%

Use of Heavy Silicon Oil as Intraocular Tamponade for Inferior Retinal Detachment Complicated by Proliferative Vitreoretinopathy: A Multicentric Experience

Mete¹,

Parolini²,

Maggio³

et al. 2023

Ophthalmologica

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Introduction: This is a multicentric study on the use of heavy silicon oil (HSO) as an intraocular tamponade for inferior retinal detachment (RD) complicated by proliferative vitreoretinopathy (PVR). Methods: 139 eyes treated for RD with PVR were included in the study. 10 (7.2%) were affected by primary RD with inferior PVR, while 129 (92.8%) were affected by recurrent RD with inferior PVR. 102 eyes (73.9%) had received a silicon oil (SO) tamponade in a previous intervention prior to receiving HSO. Mean follow-up was 36.5 (standard deviation = 32.3) months. Results: The median interval between HSO injection and removal was 4 months (interquartile range: 3). At the time of HSO removal, the retina was attached in 120 eyes (87.6%), whereas in 17 eyes (12.4%), it had re-detached while the HSO was in situ. 32 eyes (23.2%) showed recurrent RD. A subsequent RD relapse was observed in 14.2% of cases with no RD at the time of HSO removal, and in 88.2% if an RD was present at the time of HSO removal. Advancing age showed a positive association with retinal attachment at the end of follow-up, while the risk of RD relapse at the end of the follow-up showed a significant negative association with HSO tamponade duration and with the use of SO rather than air or gas as post-HSO tamponade materials. Mean best corrected visual acuity was 1.1 logarithm of minimum angle of resolution at all follow-up time points. 56 cases (40.3%) needed treatment for elevated intraocular pressure (IOP), with which no clinically relevant variables were associated during follow-up. Conclusion: HSO represents a safe and effective tamponade in cases of inferior RD with PVR. The presence of RD at the time of HSO removal is a negative prognostic factor for the development of a subsequent RD relapse. According to our findings, in cases of RD at the time of HSO removal, a short-term tamponade should definitely be avoided, in favor of SO. Special attention must be paid to the risk of IOP elevation, and patients should be closely monitored.

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“…Therefore, geometric changes more than contact variation may influence clinical success rate, as scleral indentation undoubtedly contrasts with retinal shortening 18 and, indirectly, PVR development. 19 , 20 Head positioning is also considered, with the aim of improving SiO–retinal contact, at least in some sectors, but it remains a matter of debate because of the intrinsic difficulty of maintaining the prescribed posture, the uncertain benefits, 21 dubious compliance, and possible drawbacks. 22 …”

Section: Discussionmentioning

confidence: 99%

Silicone Oil Tamponade–Retina Contact in Highly Myopic Eyes With and Without Encircling Bands: A Computational Fluid Dynamics Study

Rossi

Querzoli

Badas

et al. 2022

Trans. Vis. Sci. Tech.

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Purpose To investigate the behavior of silicone oil (SiO) at a steady equilibrium and during saccades in pseudophakic highly myopic eyes with posterior staphyloma with and without an encircling band and compare it to behavior in emmetropic eyes. The SiO–retina contact area and shear stress were calculated by computational fluid dynamics. Methods A numerical model of an emmetropic eye and a myopic eye with and without scleral band underwent a saccade of 50°/0.137 s. The vitreous chamber surface was divided into superior and inferior 180° sectors: lens, pre-equator, post-equator, and macula. SiO–retina contact was evaluated as a function of fill percentages between 80% and 90% for standing, 45° upward tilt, and supine patients. Maximum and average shear stress were calculated. Results Overall, SiO–retina contact ranged between 40% and 83%; fill percentage varied between 80% and 95%. Neither the encircling scleral band nor the staphyloma significantly affected the SiO–retina contact area, although the presence of a scleral band proved disadvantageous when gazing 45° upward. The inferior retina–SiO contact remained below 40% despite 95% SiO fill. The SS significantly increased at the scleral band indentation and decreased elsewhere. The staphyloma greatly reduced shear stress at the macula. Conclusions The presence of a myopic staphyloma reduces shear stress at the macula but does not alter SiO–retina contact significantly. The apposition of a 360° scleral band may reduce SiO–retina contact at least in some postures and increases the SS at the indentation. Translational Relevance Assessing SiO–retina contact when vitreous chamber geometry changes according to pathologic or iatrogenic modifications allows accurate prediction of real-life tamponade behavior and helps explain surgical outcomes.

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Vitrectomy with scleral buckling versus with inferior retinectomy in treating primary rhegmatogenous retinal detachment with PVR and inferior breaks

Abstract: Similar anatomical and functional outcomes were achieved by combining PPV with scleral buckle or inferior retinectomy for treatment of primary RRD with PVR and inferior breaks.

Cited by 12 publications

References 28 publications

Densiron 68 Heavy Silicone Oil as a Short-Term Intraocular Tamponade for Macula-on Inferior Retinal Detachments—a Case Series

Densiron 68 Heavy Silicone Oil as a Short-Term Intraocular Tamponade for Macula-on Inferior Retinal Detachments—a Case Series

Use of Heavy Silicon Oil as Intraocular Tamponade for Inferior Retinal Detachment Complicated by Proliferative Vitreoretinopathy: A Multicentric Experience

Silicone Oil Tamponade–Retina Contact in Highly Myopic Eyes With and Without Encircling Bands: A Computational Fluid Dynamics Study

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