A new heavy silicone oil (HWS 46-3000) used as a prolonged internal tamponade agent in complicated vitreoretinal surgery - A pilot study

Purpose: To report the results of a prospective pilot study using a new heavy agent, HWS 46-3000, as long-term endotamponade in complicated retinal detachment. Methods: Thirty-two consecutive patients were enrolled in the study. Indications for enrollment included retinal detachment with proliferative vitreoretinopathy arising from inferior or posterior tears. The patients underwent pars plana vitrectomy, membrane peeling, and HWS 46-3000 filling. Follow-up examinations were scheduled at 1 day to 7 days and 1 month to 3 months after initial surgery and 7 days and 1 month to 6 months after endotamponade removal. Results: At baseline examination, mean best-corrected Snellen visual acuity was 2.44 logarithm of the minimal angle of resolution (logMAR). HWS 46-3000 was removed after 45 days to 96 days. Initial retinal reattachment was achieved in all eyes. HWS 46-3000 endotamponade was associated with a success rate of 84.6% with a single surgery and an overall success rate of 100% at 6 months with the second operation and conventional silicone oil endotamponade. At 6 months, mean best-corrected visual acuity was +1.09 logMAR (P < 0.0001). Complications were posterior subcapsular cataract formation (100%), membrane formation (3 eyes, 9%), and increased intraocular pressure (1 eye). Emulsification and intraocular inflammation were not observed. Conclusion: HWS 46-3000 was well tolerated, effective in the inferior quadrants with a low incidence of membrane development. The main complication was the high rate of tamponade-related cataract formation.