Heavy internal tamponade for cases with complicated retinal detachment

The aim of this review was to compare clinical data on the efficacy and complications of heavier-than-water internal tamponades (F6 H8®, Oxane HD®, Densiron 68®) used in eyes with complicated retinal detachments.

An analysis was made of all case series with at least 10 eyes treated and cited in Medline together with results of 4 own institutional case series.

Short-term internal tamponade with each of the mentioned substances led to successful anatomic results in a relatively high percentage of eyes. The spectrum of complications presented a considerable variation among studies. Data indicate the following trends: F6 H8® was reported to develop emulsification in a relatively high percentage of treated cases and was reported to be related with a high risk of long-term chronic hypotony. Eyes with Oxane HD® presented a relatively high rate of clinically significant inflammatory reactions and secondary membrane formation. Use of Densiron 68® was relatively frequently associated with emulsification.

The heterogeneity of available clinical data does not allow a definitive comparison of the 3 heavier-than-water endotampondes. The data so far available seem to indicate as a trend that Densiron 68 may provide advantages compared to other substances concerning the relative incidence of severe complications. On the background of relatively high rates of heavy silicone complications it seems reasonable to regard conventional "light" silicones as first choice if a silicone endotamponade is desired and no need for a gravity effect of the endotamponade is indicated.