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BioMed Research International
Volume 2014, Article ID 574825, 16 pages
http://dx.doi.org/10.1155/2014/574825
Review Article

Heavy Silicone Oil and Intraocular Inflammation

1Department of Medical and Surgical Specialties, Radiological Specialties and Public Health, Ophthalmology Clinic, University of Brescia, Viale Europa 15, 25123 Brescia, Italy
2Department of Health Science, Ophthalmology Clinic, University of Molise, Via De Sanctis 1, 86100 Campobasso, Italy
3Dipartimento di Oftalmologia, Istituto Clinico Sant’Anna, Via del Franzone 31, 25126 Brescia, Italy
4Department of Neurological Sciences, Reproductive Sciences and Dentistry, Federico II University, Via Pansini 5, 80121 Naples, Italy

Received 20 January 2014; Accepted 19 June 2014; Published 8 July 2014

Academic Editor: Kenneth Li

Copyright © 2014 Francesco Morescalchi et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

In the past two decades, many advances have been made in vitrectomy instrumentation, surgical techniques, and the use of different tamponade agents. These agents serve close retinal breaks, confine eventual retinal redetachment, and prevent proliferative vitreoretinopathy (PVR). Long-acting gases and silicone oil are effective internal tamponade agents; however, because their specific gravity is lower than that of the vitreous fluid, they may provide adequate support for the superior retina but lack efficacy for the inferior retina, especially when the fill is subtotal. Thus, a specific role may exist for an internal tamponade agent with a higher specific gravity, such as heavy silicone oils (HSOs), Densiron 68, Oxane HD, HWS 45-300, HWS 46-3000, and HeavySil. Some clinical evidence seems to presume that heavy tamponades are more prone to intraocular inflammation than standard silicone if they remain in the eye for several months. In this review, we discuss the fundamental clinical and biochemical/molecular mechanisms involved in the inflammatory response after the use of heavy tamponade: toxicity due to impurities or instability of the agent, direct toxicity and immunogenicity, oil emulsification, and mechanical injury due to gravity. The physical and chemical properties of various HSOs and their efficacy and safety profiles are also described.