Systematic review and meta-analysis of Densiron-68 anatomic outcomes and complications in the surgical management of retinal detachment.

Abstract

Objective: To summarize the anatomical reattachment rates, functional outcomes, and complications associated with Densiron-68 in retinal detachment (RD) surgery.

Methods: Following a systematic literature search, primary studies evaluating outcomes associated with Densiron-68 in adult RD surgery between January 2000 and May 2022 were included. Exclusion criteria included secondary studies, non-English language, and those in pediatric populations. The primary endpoints of interest were anatomical reattachment rate, and reported complications associated with Densiron-68.

Results: Twenty-eight studies (927 eyes) were included. Mean follow-up time was 41.9 weeks (IQR: 32.4-52.0 weeks). The weighted mean preoperative and postoperative BCVA was 1.38 ± 0.64 logMAR (20/500 Snellen) and 0.86 ± 0.55 logMAR (20/150 Snellen), respectively (p < 0.001). Anatomical reattachment rate after a single surgery was 72.5% overall (n = 672 eyes), with most redetachments occurring while Densiron-68 was in situ (46%; n = 81/255 eyes). Postoperatively, 29 complications were identified. The three most common were raised intraocular pressure (IOP) (n = 251 eyes; 27.1%), intraocular inflammation (n = 182 eyes; 19.6%), and emulsification (n = 160 eyes; 17.3%). Densiron-68 was significantly associated with an increased risk of elevated intraocular pressure postoperatively than traditional silicone oil (RR: 1.83 95% CI: 1.25-2.67; p = 0.001). The overall GRADE certainty of evidence for included studies was determined to be low due to the risk of bias, moderate imprecision in results due to wide confidence intervals, small studies, and few events within comparative studies, and moderate to high heterogeneity impacting consistency of evidence.

Conclusions: Densiron-68 is a heavy silicone oil with clinical utility in retinal detachment surgery that has good primary anatomical reattachment rates and overall improvement in BCVA preoperatively to postoperatively. The authors highlight the anatomical and functional outcomes of Densiron-68 and the reported range of complications associated with its use, of which the majority were reversible or treatable with appropriate therapies.