Abstract

SA.10.02

Long-term results of primary pars-plana-vitrectomy with Densiron 68® in eyes with complicated retinal detachment

Heinrich Gerding, Vlassios Loukopoulos, Juliane Riese, Lars Hefner, Conny Meier, Zoi Liampa, Melanie Timmermann
Augenzentrum Klinik Pallas, Department of Retinology, Olten, Schweiz

Objective
To analyze the long-term anatomical results, functional outcome and complications in eyes treated with heavy internal tamponade during primary retinal detachment surgery using Densiron 68®.
Methods
Densiron was applied in 26 eyes (26 patients, 16 male, 10 female, median age 61.5, range 13-91 years). Treated eyes were presenting PVR stage A in 2 cases, stage B in 6 cases, stage C1-C3 in 17 cases, and stage D1 in 1 case. 22 of 26 eyes presented with a macula-off retinal detachment; 6 of these with partial foveal detachment. None of the cases received additional buckling during primary vitrectomy. Densiron internal tamponade was removed after a median of 62 days (range 17 to 99 days). 23 of 26 eyes were supplied with a mildly impressing encircling band at the time of Densiron removal. Mean follow-up was 15.1±12.1 months (median 11.3, range 3-43 months).
Results
Complete primary retinal attachment was achieved in 26/26 eyes. 1 of 26 eyes developed a severe PVR and secondary detachment before removal of the internal tamponade. 3 of 26 eyes developed a redetachment centrally to the encircling band repaired by secondary intervention. At the end of the follow-up all eyes presented with attached retina; in 3 of these a limited retinal detachment anterior to the cerclage was observed. LogMar visual acuity improved from a preoperative level of 1.2±0.96 (median 0.8) to 0.79±0.49 (median 0.72) at 3 months, 0.64±0.38 (median 0.64) at 6 months and 0.44±0.34 (median 0.3) at 12 months. 16 of 17 phakic eyes developed a secondary cataract (15 of 16 posterior subcapsular type) during follow-up. Dispersed Densiron occurred in 10 of 26 eyes in the anterior segment, 1 case presented a gross inverse pseudohypopyon. The majority of eyes (19 of 26) needed local antiglaucomatous medication during or after the period of internal tamponde; 6 of these until the end of the follow-up period. Chronic hypotony occurred in none of the eyes.
Conclusions
Results of this study indicate that Densiron 68® is an effective and safe heavy internal tamponade substance yielding functionally favourable results when applied in primary retinal detachment surgery with inferior retinal defects and PVR.

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