Purpose: To evaluate the safety and efficacy of Densiron-68 heavy silicone oil in the clinical management of complex retinal detachments with proliferative vitreoretinopathy (PVR).
Methods: We present a prospective, interventional noncomparative case series of 80 eyes of 79 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 PVR stages B-CA4, including posterior or inferior retinal breaks and the patient's inability to posture.
Results: Patients were 59.1 (+/-18.1) years old, male:female =48:32, R:L=40:40. Fifty-six patients (70%) had previous unsuccessful retinal surgery, and 24 (30%) received heavy silicone oil at their first procedure. The extent of the detachments was 2.46 quadrants (+/-0.83) with macular involvement in 49 cases (61%). Fifty-six (67.5%) patients achieved retinal reattachment with one retinal operation and no tamponade, 64 (80%) achieved retinal reattachment with more than one operation and no tamponade, and 72 (90%) achieved a flat retina with tamponade in situ. Visual acuity rose from 1.48 LogMar (+/-0.91) to 1.12 (+/-0.82; p=0.009). Densiron was removed after 126 days (+/-55.1).
Conclusion: The treatment of PVR remains challenging. 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 for the surgeon. We regard the use of heavy as well as conventional silicone oil as complementary to each other.
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