Schwere Tamponade bei komplizierten inferioren Netzhautablösungen

Zusammenfassung

Hintergrund: Inferiore Netzhautablösungen mit proliferativer Vitreoretinopathie sind schwierig zu behandeln. Ziel dieser Fallserie war die Beurteilung der Effizienz und Zuverlässigkeit von Densiron bei der Behandlung von komplizierten Netzhautablösungen.

Anamnese und Befunde: 6 Augen von 6 Patienten mit Netzhautablösung und inferiorer proliferativer Vitreoretinopathie Grad 3 wurden mittels Pars-plana-Vitrektomie und Injektion von Densiron behandelt. Die Patienten waren durchschnittlich 61 Jahre alt. 3 Patienten hatten bereits einen erfolglosen vitreoretinalen Eingriff im Vorfeld und bei 3 Patienten wurde Densiron beim ersten vitreoretinalen Eingriff angewandt. Die mittlere Ausdehnung der Netzhautablösung erstreckte sich über mindestens 2 Quadranten mit einer Makulabeteiligung in 3 Fällen. Der durchschnittliche Visus präoperativ betrug 29,2 ETDRS. 

Therapie und Verlauf: Densiron wurde nach durchschnittlich 58 Tagen entfernt. Bei 5 Patienten zeigte sich eine Wiederanlage der Netzhaut ohne weitere Tamponade, in einem Fall erst nach erneuter Injektion von konventionellem Silikonöl. 4 – 6 Wochen postoperativ betrug der durchschnittliche Visus 50,2 ETDRS. Die häufigste Komplikation war ein Anstieg des Augendrucks, welcher sich nach Entfernung des Densirons normalisierte.

Schlussfolgerungen: Densiron verbessert die Tamponade der inferioren Netzhaut. Demzufolge könnte die klinische Anwendung in ausgewählten Fällen zur erfolgreichen Behandlung von komplizierten Netzhautablösungen mit inferiorer proliferativer Vitreoretinopathie beitragen.

Abstract

Background: 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.

History and Signs: 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. 

Therapy and Outcome: 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.

Conclusions: 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.

Schlüsselwörter

Densiron - schwere Tamponade - komplizierte inferiore Netzhautablösung - proliferative Vitreoretinopathie

Key words

Densiron - heavy tamponade - complicated inferior retinal detachment - proliferative vitreoretinopathy

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