Schwere Tamponaden – Hintergrund und Zukunftsperspektiven

 

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Zusammenfassung

Die proliferative Vitreoretinopathie (PVR) der unteren Netzhaut bleibt klinisch anspruchsvoll. Um eine bessere Tamponadewirkung im unteren Netzhautbereich zu erzielen, wurden Substanzen entwickelt, die schwerer als Wasser sind. Die Parameter, die eine optimale intraokulare Tamponade bewirken, werden diskutiert und die Einflussgrößen spezifisches Gewicht, Auftrieb, Oberflächenspannung und Viskosität definiert. Perfluorcarbone und teilfluorinierte Alkane werden häufig mit einer Emulsifikation der Tamponade, intraokularer Entzündung und Druckanstiegen assoziiert. Diese Nebenwirkungen sind bei Mischungen dieser Substanzen mit Silikonölen (schwere Silikonöle) geringer ausgeprägt. 2 kürzlich entwickelte Substanzen, Oxane HD und Densiron 68, werden klinisch gut toleriert mit dem konventionellen Silikonöl ähnlichen Nebenwirkungen. Schwere Tamponaden verbessern die inferiore Tamponade und können als neue Generation von Glaskörpertamponaden gesehen werden.

Abstract

Proliferative vitreoretinopathy in the inferior retina remains clinically challenging. Heavier-than-water intraocular tamponades have been developed to improve inferior tamponading properties. The parameters of an optimal intraocular tamponade are defined and the influences of the specific gravity, buoyancy, interfacial tension, and viscosity are discussed. Perfluorocarbon liquids and partially fluorinated alkanes were associated with tamponade emulsification, intraocular inflammation, and rises in intraocular pressure that were less prominent in admixtures of these substances with silicone oil (heavy silicone oils). Two recently developed heavy silicone oil tamponades, Oxane HD and Densiron 68, are well tolerated and have entered clinical practice. The side effects are associated with the chemical properties of the tamponading agent and seem comparable to those seen with conventional silicone oil. Heavy silicone oil tamponade improves inferior tamponade and may be considered as a new generation of intraocular tamponades.

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Prof. Dr. Antonia M. Joussen

Universitäts-Augenklinik Düsseldorf

Moorenstr. 5

40225 Düsseldorf

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