Adriano Carnevali, Domenico Chisari, Alessandra Mancini, Massimiliano Borselli, Giovanni Scalia, Giovanna Carnovale Scalzo, Andrea Lucisano, Vincenzo Scorcia
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引用次数: 0
Abstract
Introduction: Inferior retinal detachment (I-RD) complicated by proliferative vitreoretinopathy (PVR) is challenging to treat and prone to recurrence (RDR). Heavy silicone oil (HSO) tamponades such as Densiron 68 have improved inferior tamponade and are widely used in this setting. It was evaluated whether prolonged Densiron-68 tamponade (≥3 months) protects against RDR after oil removal, overall and in patients with previous failed retinal detachment (RD) surgery.
Methods: We retrospectively reviewed 112 consecutive eyes with rhegmatogenous I-RD and grade-C PVR treated with PPV and Densiron 68. Mean follow-up after oil removal was ~12 months. Multivariate logistic regression was performed including laterality, sex, age, tamponade duration, previous failed RD surgery, previous SO tamponade, lens status, and 360° laser retinopexy. Patients were then stratified by history of failed RD surgery (History-/History+) and by tamponade duration (Short <3 months vs Long ≥3 months).
Results: After Densiron-68 removal, 24 eyes (29.3%) developed RDR. Anatomical success was 63.0% with one operation and no tamponade, 82.6% after additional procedures, and 92.4% including eyes stable with silicone oil in situ. In multivariate analysis, no covariate was significantly associated with RDR; prolonged tamponade was not protective overall (OR 1.02; p=0.867). Previous failed RD surgery showed the strongest association with higher recurrence risk (OR 1.15; p=0.070). Stratified analysis revealed that eyes with previous failed RD surgery had significantly higher odds of RDR (OR 4.44; p=0.0028). Within this group, prolonged tamponade was associated with lower recurrence compared with short tamponade (OR 3.96; p=0.025). In eyes without prior surgery, tamponade duration had no effect (p=0.979). Most recurrences (84,85%) occurred within three months from surgery.
Conclusion: Prolonged Densiron-68 tamponade did not reduce RDR risk in the overall cohort but conferred protection in eyes with previous failed RD surgery. Extending tamponade may therefore be justified in specific high-risk group of patients, while routine prolongation in lower-risk cases appears unnecessary. Prospective validation is needed to refine timing of HSO removal and optimize outcomes.
期刊介绍：
Published since 1899, ''Ophthalmologica'' has become a frequently cited guide to international work in clinical and experimental ophthalmology. It contains a selection of patient-oriented contributions covering the etiology of eye diseases, diagnostic techniques, and advances in medical and surgical treatment. Straightforward, factual reporting provides both interesting and useful reading. In addition to original papers, ''Ophthalmologica'' features regularly timely reviews in an effort to keep the reader well informed and updated. The large international circulation of this journal reflects its importance.
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