Indikation zum Einsatz verschiedener Endotamponaden

Zusammenfassung

Die Verwendung von Silikonöl Polydimethylsiloxan (PDMS) als Endotamponade ist zu einem Goldstandard in der Netzhautchirurgie geworden. Ein Nachteil dieser Endotamponade bei Netzhautablösung ist die häufig nicht ausreichende Tamponadewirkung in der unteren Zirkumferenz oder im posterioren Anteil des Auges, insbesondere wenn bereits proliferative Veränderungen vorliegen. Die Verwendung von schweren Ölen könnte bei diesen Formen von Vorteil sein. Über die klinische Erfahrung mit Densiron® 68, einem Gemisch von PDMS mit Perfluorhexyloktan (F6 H8), liegen inzwischen erste klinische monozentrische Beobachtungen vor, über die berichtet wird. Da auch die Verwendung der schweren Flüssigkeit F 6 H8 allein als Endotamponade zugelassen ist und bei dieser Tamponade von Komplikationen wie Emulgation und entzündlichen Reaktionen berichtet wurde, werden zusätzlich auch die hierzu vorliegenden Untersuchungen und Bewertungen dargestellt. Schwere Silikonölendotamponaden haben den Vorteil einer kürzeren Tamponadezeit und einfacherer Lagerung für den Patienten. Weitere Forschungen zur Entwicklungen von schweren Ölen mit geringerer Neigung zur Emulgation laufen derzeit.

Abstract

The use of polydimethylsiloxane (PDMS) as silicone oil endotamponade has become a gold standard in retinal surgery. In cases of complicated retinal detachment with inferior and posterior retinal detachment this tamponade may be insufficient, and heavy silicone oils may be superior in such cases. Monocentric studies about use of the heavy silicone oil Densiron® 68, a mixture of PDMS with perfluorohexyloctane (F6 H8), are reviewed. Meanwhile, F 6 H8 is approved as sole endotamponade, but complications such as emulsification and inflammation associated with the use of only F 6 H8 as endotamponade are reported and will also be reviewed. An advantage of heavy silicone oils is the relatively short residence time of the endotamponade. An uncomfortable “head down” position of the patients after surgery is not necessary. Current research focusses on developing new heavy silicone oils with a lower tendency to emulsify.

Schlüsselwörter

Densiron 68 - Perfluorkarbon - schweres Silikonöl - komplizierte Amotio retinae - Netzhautablösung - Endotamponade

Key words

Densiron 68 - perfluorocarbon liquids - heavy silicone oil - complicated retinal detachment - endotamponade agents

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