Brunner M, Lang C, Valmaggia C
Augenklinik, Kantonsspital St. Gallen, Schweiz.
Klin Monbl Augenheilkd. 2012 Apr;229(4):407-10. doi: 10.1055/s-0031-1299271. Epub 2012 Apr 11.
Retinal detachment with inferior proliferative vitreoretinopathy is a difficult to treat problem. The aim of our study was to assess the safety and efficacy of Densiron in the clinical management of complicated retinal detachment.
6 eyes of 6 consecutive patients presenting with a retinal detachment with inferior proliferative vitreoretinopathy grade 3 were treated with pars plana vitrectomy and injection of Densiron. The mean age of the patients was 61 years. 3 patients had a previous unsuccessful vitreoretinal surgery and 3 patients had Densiron as a first procedure. The extent of detachment was at least 2 or more quadrants with macular involvement in 3 cases. Preoperatively the mean visual acuity was 29.2 letters with ETDRS.
Densiron was removed after an average of 58 days. 5 patients achieved retinal re-attachment without further tamponade, and 1 patient after additional injection of conventional silicon oil. 4 - 6 weeks after removal of Densiron the mean visual acuity was 50.2 letters with ETDRS. The most common complication was an elevated intraocular pressure during endotamponade, which resolved following removal of the agent.
Densiron improves inferior tamponade, and in clinical practice may be considered to increase the anatomic success rate in selected cases of complicated retinal detachment with inferior proliferative vitreoretinopathy.
伴有下方增殖性玻璃体视网膜病变的视网膜脱离是一个难以治疗的问题。我们研究的目的是评估Densiron在复杂视网膜脱离临床治疗中的安全性和有效性。
连续6例患有3级下方增殖性玻璃体视网膜病变的视网膜脱离患者的6只眼接受了玻璃体切割术和平坦部玻璃体切除术并注射了Densiron。患者的平均年龄为61岁。3例患者既往玻璃体视网膜手术失败，3例患者首次接受Densiron治疗。脱离范围至少为2个或更多象限，3例累及黄斑。术前平均ETDRS视力为29.2个字母。
平均58天后取出Densiron。5例患者在未进一步填塞的情况下实现视网膜复位，1例患者在额外注射传统硅油后实现视网膜复位。取出Densiron后4 - 6周，平均ETDRS视力为50.2个字母。最常见的并发症是内填塞期间眼压升高，在取出药物后眼压恢复正常。
Densiron可改善下方填塞，在临床实践中，对于伴有下方增殖性玻璃体视网膜病变的复杂视网膜脱离的特定病例，可考虑使用Densiron以提高解剖复位成功率。
