title: The combined use of heavy and light silicone oil in the treatment of complicated retinal detachment with 360º retinal breaks: tamponade effect or filling effect?
abstract: BACKGROUND
  This study aims to report the safety and effi cacy of the combined use of 70% Densiron®-68 and 30% polydimethysiloxane as a temporary vitreous substitute after pars plana vitrectomy (PPV) in selected cases of retinal detachment with superior and inferior retinal breaks.
  
  
  METHODS
  Fifty consecutive eyes of 50 patients affected by complicated retinal detachment with retinal breaks of the superior and inferior quadrants associated with proliferative vitreoretinopathy (PVR) of grade C2 or more, underwent a pars plana vitrectomy and a combination internal tamponade with 70% Densiron®-68 and 30% silicone oil. The main outcome measures were visual acuity, retinal attachment, intraocular pressure (IOP) and incidence of complications.
  
  
  RESULTS
  The mean best-corrected visual acuity rose from 1.4 logMAR to 0.7 logMAR (P <0.01). Initial retinal reattachment was achieved in 48 (96%) patients. In 15 patients (30%), IOP increased over 21 mmHg. The main complications were redetachment at the 3 month follow-up in 12/48 cases (25%) and cataract formation in 13/21 phakic eyes (62%).
  
  
  CONCLUSIONS
  This combination tamponade comprised lighter and heavier oil compounds was well tolerated and effective. It may be a useful tool for the treatment of retinal detachment complicated with breaks and PVR involving the upper and lower quadrants.
authors.affiliation: Ospedali Riuniti di Bergamo, Bergamo, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Zenoni
authors.forename: Natalia
authors.initials: N
authors.lastname: Comi
authors.forename: Piero
authors.initials: P
authors.lastname: Fontana
authors.forename: Mario R
authors.initials: MR
authors.lastname: Romano
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D004129:Dimethylpolysiloxanes / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D012008:Recurrence; D012163:Retinal Detachment / Q000209:etiology / Q000473:pathology / Q000628:therapy*; D012189:Retrospective Studies; D012827:Silicone Oils / Q000627:therapeutic use*; D060205:Therapeutic Occlusion / Q000379:methods*; D016896:Treatment Outcome; D014792:Visual Acuity; D014821:Vitrectomy; D018630:Vitreoretinopathy, Proliferative / Q000150:complications*
chemical_list: D004129:Dimethylpolysiloxanes; D012827:Silicone Oils; C539718:densiron-68