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重度心包填塞的概念——机遇与局限

The concept of heavy tamponades-chances and limitations.

作者信息

Joussen Antonia M, Wong David

机构信息

Department of Ophthalmology, University of Duesseldorf, Moorenstr. 5, 40225 Düsseldorf, Germany.

出版信息

Graefes Arch Clin Exp Ophthalmol. 2008 Sep;246(9):1217-24. doi: 10.1007/s00417-008-0861-0. Epub 2008 Jun 11.

Abstract

BACKGROUND

Proliferative vitreoretinopathy in the inferior retina remains clinically challenging. Heavier than water intraocular tamponades have been developed to improve inferior tamponading properties. In addition to inferior PVR, there seem to be other applications such as persistent macular holes or PVR in trauma eyes.

MATERIALS AND METHODS

Review of the literature on clinical application of heavy tamponades. The review also discusses the theoretical background of heavy tamponades and possible future developments.

RESULTS

The parameters of an optimal intraocular tamponade are defined, and the influences of the specific gravity, buoyancy, interfacial tension, and viscosity are discussed. Perfluorocarbon liquids and partially fluorinated alkanes were associated with tamponade emulsification, intraocular inflammation, and rise in intraocular pressure that was less prominent in admixtures of these substances with silicone oil (heavy silicone oils). Two recently developed heavy silicone oil tamponades, Oxane HD and Densiron 68, are well-tolerated and have entered clinical practice. The side effects are associated with the chemical properties of the tamponading agent, and seem comparable to the ones seen with conventional silicone oil.

CONCLUSION

Heavy silicone oil tamponade improves inferior tamponade, and may be considered a new generation of intraocular tamponades.

摘要

背景

视网膜下方的增殖性玻璃体视网膜病变在临床上仍然具有挑战性。已研发出比水重的眼内填塞物以改善下方填塞性能。除了下方增殖性玻璃体视网膜病变外,似乎还有其他应用,如持续性黄斑裂孔或外伤性眼的增殖性玻璃体视网膜病变。

材料与方法

回顾关于重填塞物临床应用的文献。该综述还讨论了重填塞物的理论背景及可能的未来发展。

结果

定义了最佳眼内填塞物的参数,并讨论了比重、浮力、界面张力和粘度的影响。全氟化碳液体和部分氟化烷烃与填塞物乳化、眼内炎症以及眼压升高有关,而这些物质与硅油(重硅油)混合时眼压升高不太明显。最近研发的两种重硅油填塞物,Oxane HD和Densiron 68,耐受性良好并已进入临床应用。副作用与填塞剂的化学性质有关,似乎与传统硅油所见的副作用相当。

结论

重硅油填塞可改善下方填塞,可被视为新一代眼内填塞物。

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