{ "schemaVersion": 2, "eyebrow": "Vitreoretinal Surgery", "title": "Agents for Vitreous Tamponade", "summary": "Select air, expansile gas, or silicone oil after pars plana vitrectomy by matching tamponade duration, break location, proliferative vitreoretinopathy risk, postoperative positioning feasibility, and need for air travel or repeat surgery.", "seoDescription": "Clinical selection of air, SF6, C3F8, and silicone oil tamponade for retinal detachment repair, including duration, positioning, risks, and removal.", "clinicalQuestion": "How should vitreoretinal surgeons select air, gas, or silicone oil tamponade after repair of retinal detachment?", "specialty": "Ophthalmology", "audience": "U.S. physicians and medical trainees", "tags": [ "vitreous tamponade", "silicone oil", "SF6", "C3F8", "retinal detachment", "pars plana vitrectomy", "proliferative vitreoretinopathy" ], "keyTakeaways": [ "Choose tamponade after retinopexy according to the required duration of break coverage, break location, proliferative vitreoretinopathy severity, and the patient's ability to maintain postoperative positioning. [15][16]", "For complete gas-fluid exchange, typical nonexpansile concentrations are SF6 20% and C3F8 14%; air resorbs in 5–7 days, SF6 in about 2 weeks, and C3F8 in about 8 weeks. [2][16]", "Gas provides substantially greater surface-tension force and buoyancy than silicone oil but requires positioning and creates perioperative anesthesia and travel constraints while present. [2][10][16]", "Silicone oil provides long-term tamponade, permits fundus visualization, and can reduce dependence on prolonged prone positioning, but requires later surgical removal and carries risks of emulsification, ocular hypertension, cataract, corneal complications, and unexplained visual loss. [5][7][19]", "In severe proliferative vitreoretinopathy, C3F8 and silicone oil had similar retinal reattachment, visual, and complication outcomes in the Silicone Study; C3F8 performed better than SF6 for reattachment in PVR grade C3. [12]" ], "sections": [ { "id": "select-the-tamponade", "eyebrow": "Procedure Planning", "heading": "Select tamponade by durability, break geometry, and postoperative constraints", "intro": "Use tamponade after retinopexy to prevent recurrent subretinal fluid passage while chorioretinal adhesion forms.", "paragraphs": [ "At the end of pars plana vitrectomy, first determine whether short-term coverage is adequate or whether the eye requires weeks of internal support. Air, SF6, and C3F8 are temporary agents; silicone oil remains intraocular until surgically removed. The selection should reflect break location, retinal-detachment complexity, anticipated postoperative positioning, and patient-specific feasibility rather than duration alone. [15][16]", "For uncomplicated rhegmatogenous retinal detachment treated with vitrectomy, gas and silicone oil have comparable primary reattachment rates, whereas gas tamponade has better functional outcomes in comparative evidence. This supports gas when durable tamponade is needed but no compelling anatomic or practical reason favors oil. Interpret this comparison cautiously because the meta-analysis found no randomized trials and selection bias is likely in observational comparisons. [23]", "Buoyancy makes standard gas and light silicone oil most effective at the superior retina. Gas has greater buoyancy and approximately 30-fold greater tamponade tension than silicone oil, but its effect is temporary. Silicone oil may be favored when long-term support is required, when the patient cannot sustain prescribed postoperative positioning, or when ongoing fundus examination through a clear medium is important. [2][7][16]" ], "bullets": [ "Use air when a short tamponade interval is sufficient; after complete gas-fluid exchange, intraocular air generally resorbs in 5–7 days. [2][16]", "Use nonexpansile SF6 when approximately 2 weeks of tamponade is appropriate; a commonly used concentration is 20%. [2][16]", "Use nonexpansile C3F8 when a longer tamponade interval is needed; a commonly used concentration is 14%, with resorption at about 8 weeks after complete gas-fluid exchange. [2][16]", "Use silicone oil when the case requires long-term internal tamponade or when gas-related positioning constraints are impractical; plan a separate removal procedure once the retina is sufficiently stable. [5][7][16]" ], "subsections": [], "table": { "caption": "Practical comparison of commonly used postoperative tamponades after complete gas-fluid exchange. [2][15][16]", "columns": [ "Agent", "Typical concentration or status", "Approximate intraocular duration", "Selection advantage", "Important limitation" ], "rows": [ [ "Air", "Nonexpansile [15][16]", "5–7 days [2][16]", "Shortest temporary tamponade option when low PVR risk permits. [2]", "Short duration may be insufficient when prolonged support is required. [2][15]" ], [ "SF6", "20% nonexpansile [2][16]", "About 2 weeks [2][16]", "Intermediate-duration gas tamponade. [2][16]", "Gas expansion and persistence require positioning and avoidance of nitrous oxide while the bubble remains. [10][16]" ], [ "C3F8", "14% nonexpansile [2][16]", "About 8 weeks [2][16]", "Longest commonly used gas duration; in severe PVR, C3F8 was more effective than SF6 for retinal reattachment during the first year. [12]", "Longest gas-related functional restrictions and prolonged visual obstruction from the bubble. [2][16]" ], [ "Silicone oil", "Permanent until surgical removal [2][16]", "Until removal [2][16]", "Long-term tamponade, clear fundus visualization, and less reliance on prolonged prone positioning. [7]", "Requires removal surgery and can cause emulsification, ocular hypertension, cataract, corneal complications, or unexplained visual loss. [5][19]" ] ] } }, { "id": "gas-tamponade", "eyebrow": "Air and Gas", "heading": "Use air or expansile gas when temporary superior tamponade is sufficient", "intro": "Gas selection is primarily a duration decision once the retinal configuration and postoperative plan support a temporary buoyant tamponade.", "paragraphs": [ "Air is a reasonable final tamponade when PVR risk is low and only brief support is needed after retinopexy. In a primary retinal-detachment series, air was described as particularly applicable when PVR risk was low; it also serves during exchange and removal of perfluorocarbon liquid. Once retinal pigment epithelium–retina adhesion is established, the barrier function of the tamponade is no longer required. [2]", "Select SF6 versus C3F8 according to the required support interval. After complete exchange, 20% SF6 lasts about 2 weeks and 14% C3F8 about 8 weeks. Do not substitute undiluted expansile-gas behavior for the expected behavior of a nonexpansile mixture: 100% SF6 can expand about twofold over 1–2 days, whereas 100% C3F8 can expand about fourfold over 3–4 days. [16]", "In severe PVR, evidence from the Silicone Study supports C3F8 rather than SF6 when a gas strategy is chosen: C3F8 was as effective as silicone oil and better than SF6 for retinal reattachment in PVR grade C3. By the end of the second year, the difference between SF6 and the other agents diminished; this time-dependent finding should not override the need for early durable tamponade in a high-risk eye. [12]" ], "bullets": [ "For pneumatic retinopexy, use small volumes of undiluted gas; for pars plana vitrectomy, use larger volumes of diluted gas, commonly SF6 20%, C2F6 16%, or C3F8 14%. [16]", "Avoid nitrous oxide anesthesia while an intraocular gas bubble is present because nitrous oxide diffuses into and expands the bubble, risking irreversible ischemic injury. [10]", "Document the gas agent and date of placement in the operative record and communicate its persistence interval when subsequent anesthesia is contemplated. [2][10][16]" ], "subsections": [], "table": { "caption": "Duration-based gas selection after complete gas-fluid exchange. [2][16]", "columns": [ "Required temporary support", "Preferred agent", "Expected persistence", "Decision consequence" ], "rows": [ [ "About 1 week", "Air [2][16]", "5–7 days [2][16]", "Consider only when brief coverage and low PVR risk are appropriate. [2]" ], [ "About 2 weeks", "SF6 20% [2][16]", "About 2 weeks [2][16]", "Choose when air is too short-lived but prolonged C3F8 persistence is unnecessary. [2][16]" ], [ "Several weeks", "C3F8 14% [2][16]", "About 8 weeks [2][16]", "Choose when the retinal repair requires the longest commonly used gas support; apply gas-related restrictions for the full bubble duration. [2][10][16]" ] ] } }, { "id": "silicone-oil", "eyebrow": "Long-Term Tamponade", "heading": "Reserve silicone oil for complex detachments or when gas is unsuitable", "intro": "Silicone oil trades stronger temporary tamponade force for sustained intraocular support and a planned removal procedure.", "paragraphs": [ "Silicone oil is a long-term internal tamponade used principally for rhegmatogenous retinal detachment and PVR. It is particularly useful in complex retinal detachment, for patients unable to comply with postoperative posturing, and when serial fundus visualization is needed while the eye remains tamponaded. Standard light oils float and preferentially support superior pathology. [1][7]", "In severe PVR, silicone oil and C3F8 had similar retinal reattachment, visual, and complication outcomes in randomized-study reporting. Thus, the clinically important discriminator is often not average efficacy but whether the patient can safely complete prolonged gas precautions and positioning, whether prolonged internal support is needed, and whether oil-specific complications are acceptable. [12]", "For inferior pathology, heavy silicone oils are designed to settle inferiorly because they are formulated with fluorinated compounds. However, heavy oils are not available in the United States according to a retinal-detachment tamponade review, so standard U.S. planning should not assume access to this option. [1][19]", "Plan silicone-oil removal as a deliberate second operation once continued tamponade is no longer judged necessary. Longer tamponade duration is associated with greater concern for emulsification and silicone-oil-related visual loss; reports increasingly advocate early removal when anatomically appropriate, with unexplained visual loss reported rarely after short-term tamponade of 8 weeks or less. [5]" ], "bullets": [ "Counsel before oil placement that silicone oil is not self-resorbing and requires surgical removal. [2][16]", "Use postoperative fundus examination to assess retinal status through oil; silicone oil transparency is an operational advantage over an intraocular gas bubble. [7]", "If inferior break support is the principal reason for considering heavy oil, distinguish availability constraints from a general indication for silicone oil. [1][19]" ], "subsections": [], "table": { "caption": "Silicone-oil selection and surveillance priorities. [1][5][7][19]", "columns": [ "Clinical situation", "Why silicone oil may be selected", "Management implication" ], "rows": [ [ "Complex retinal detachment or PVR", "Provides long-term internal tamponade rather than temporary gas support. [1][7]", "Establish a follow-up plan for retinal status, pressure-related complications, and eventual removal. [5][19]" ], [ "Patient cannot maintain prolonged postoperative positioning", "Oil permits shorter prone-positioning duration and is used when posturing is not feasible. [7]", "Weigh this practical advantage against removal surgery and oil-related adverse effects. [5][7]" ], [ "Need for ongoing fundus visualization", "Oil is transparent and allows fundus examination during tamponade. [7]", "Use serial examination to identify recurrent detachment or proliferative change before removal. [7]" ], [ "Inferior retinal pathology", "Heavy silicone oils settle inferiorly, unlike standard light oil. [1]", "Heavy oils are not available in the United States according to the cited review; use an alternative operative strategy when access is absent. [19]" ] ] } }, { "id": "complications-and-monitoring", "eyebrow": "Postoperative Surveillance", "heading": "Monitor complications according to the implanted agent and intervene before permanent sequelae", "intro": "Follow-up should target pressure, lens, cornea, retinal attachment, and oil emulsification rather than visual acuity alone.", "paragraphs": [ "Measure intraocular pressure during postoperative follow-up after either gas or silicone oil. In Silicone Study reporting, chronic elevated IOP and hypotony occurred with both C3F8 and silicone oil; elevated IOP was significantly more common with silicone oil, whereas hypotony was significantly more common with gas. A pressure abnormality should trigger examination for recurrent detachment, anterior-segment compromise, and agent-related mechanisms rather than attribution to routine postoperative change. [19]", "Assess for cataract progression after either gas or oil tamponade. Cataract formation is a common reported complication of both agents, with reported rates up to 100% in the reviewed literature. For silicone-oil eyes, also inspect for emulsified droplets and migration into the anterior chamber, because emulsification and anterior-segment oil are recognized oil-specific complications. [8][19]", "At each oil follow-up, evaluate the cornea as well as retinal attachment. At 24 months in Silicone Study reporting, overall corneal abnormality rates were not significantly different between silicone-oil and gas groups, but oil can cause corneal edema, opacity, or need for corneal transplantation within the spectrum of monitored complications. [19]", "When visual decline occurs during silicone-oil tamponade or around oil removal without an evident structural explanation, consider silicone-oil-related visual loss. The review definition is a profound decrease of more than 2 Snellen lines during oil tamponade or, more commonly, at oil removal without an apparent explanation; duration of tamponade may increase risk. [5]" ], "bullets": [ "Gas-filled eye: check IOP and retinal attachment; hypotony was relatively more common with gas than silicone oil in Silicone Study reporting. [19]", "Oil-filled eye: check IOP, cornea, lens status, retinal attachment, and signs of emulsification at serial visits. [5][8][19]", "New unexplained loss of more than 2 Snellen lines during oil tamponade or after removal warrants evaluation for silicone-oil-related visual loss after structural causes are excluded. [5]" ], "subsections": [], "table": { "caption": "Agent-directed complication surveillance after vitreoretinal tamponade. [5][8][19]", "columns": [ "Finding", "Higher-yield context", "Next clinical action" ], "rows": [ [ "Elevated IOP", "More common chronically with silicone oil than C3F8 in Silicone Study reporting. [19]", "Perform pressure-focused anterior and posterior segment assessment and manage the identified mechanism. [19]" ], [ "Hypotony", "More common with gas than silicone oil in Silicone Study reporting. [19]", "Assess retinal attachment and postoperative ocular integrity rather than assuming uncomplicated gas resorption. [19]" ], [ "Emulsified oil or anterior-chamber droplets", "Silicone oil, particularly with longer intraocular duration. [5][8]", "Reassess timing of oil removal and evaluate associated anterior-segment and pressure complications. [5][8][19]" ], [ "Unexplained visual decline", "During silicone-oil tamponade or at removal. [5]", "If loss exceeds 2 Snellen lines without apparent explanation, evaluate for silicone-oil-related visual loss and reconsider ongoing oil exposure. [5]" ] ] } }, { "id": "intraoperative-adjuncts", "eyebrow": "Intraoperative Agents", "heading": "Distinguish temporary surgical liquids from postoperative tamponades", "intro": "Perfluorocarbon liquid is primarily an intraoperative maneuvering agent, not a routine long-term postoperative substitute.", "paragraphs": [ "Use perfluorocarbon liquid intraoperatively when its high-density mechanical effect facilitates retinal unfolding or reapposition. In giant retinal tears, perfluoro-octane enabled unfolding of an inverted posterior flap and complete retinal reattachment before endophotocoagulation and final C3F8 or silicone-oil tamponade. [20]", "Do not conflate balanced salt solution, lactated Ringer solution, or hydrogels with tamponade agents: they can replace vitreous volume intraoperatively but do not supply the surface-tension barrier across retinal breaks that defines a postoperative vitreous tamponade. [12][15]", "For complex surgery requiring perfluorocarbon liquid, explicitly document the transition from the intraoperative liquid to the final air, gas, or silicone-oil agent. Air can be used for exchange and removal of perfluorocarbon liquid, after which the final temporary or long-term tamponade should match the retinal-detachment risk profile. [2]" ], "bullets": [ "Perfluoro-octane: intraoperative retinal unfolding and reapposition in giant retinal tears. [20]", "Air, SF6, C3F8, or silicone oil: postoperative agents selected to maintain break closure while retinopexy adhesion forms. [2][15][16]", "Balanced salt solution and similar aqueous fluids: volume replacement, not retinal-break tamponade. [12][15]" ], "subsections": [], "table": { "caption": "Functional distinction between intraoperative vitreous substitutes and postoperative tamponades. [2][12][15][20]", "columns": [ "Agent category", "Primary operative role", "Postoperative role" ], "rows": [ [ "Perfluorocarbon liquid", "Temporary surgical tool for retinal unfolding, reapposition, and selected maneuvers. [12][20]", "Not the standard long-term final tamponade described for retinal-detachment repair. [2][20]" ], [ "Balanced salt solution or lactated Ringer solution", "Intraoperative vitreous-volume replacement. [12][15]", "Does not provide tamponade across retinal breaks. [12][15]" ], [ "Air, SF6, C3F8, silicone oil", "Can be used at final exchange after retinal repair. [2][16]", "Provides the surface-tension barrier that limits fluid passage through retinal breaks while retinopexy adhesion develops. [2][15]" ] ] } } ], "faq": [], "references": [ { "number": 1, "title": "Silicone Oil Applications in Vitreoretinal Surgery - Nature", "detail": "www.nature.com", "url": "https://www.nature.com/nature-index/topics/l4/silicone-oil-applications-in-vitreoretinal-surgery", "authors": "www.nature.com", "host": "www.nature.com" }, { "number": 2, "title": "Thirteen year experience of vitrectomy and air tamponade for primary retinal detachment repair with clinical outcomes | Scientific Reports", "detail": "www.nature.com", "url": "https://www.nature.com/articles/s41598-024-79889-9", "authors": "www.nature.com", "host": "www.nature.com" }, { "number": 3, "title": "Biocompatibility of intraocular liquid tamponade agents: an update | Eye", "detail": "www.nature.com", "url": "https://www.nature.com/articles/s41433-021-01596-w", "authors": "www.nature.com", "host": "www.nature.com" }, { "number": 4, "title": "A new heavy internal tamponade in vitreoretinal surgery: an in vitro study | Eye", "detail": "www.nature.com", "url": "https://www.nature.com/articles/eye2008144", "authors": "www.nature.com", "host": "www.nature.com" }, { "number": 5, "title": "Silicone oil in vitreoretinal surgery: indications, complications, new developments and alternative long‐term tamponade agents - Chen - 2021 - Acta Ophthalmologica - Wiley Online Library", "detail": "onlinelibrary.wiley.com", "url": "https://onlinelibrary.wiley.com/doi/10.1111/aos.14604", "authors": "onlinelibrary.wiley.com", "host": "onlinelibrary.wiley.com" }, { "number": 6, "title": "Management of retinal detachment and myopia –... : Indian Journal of Ophthalmology", "detail": "journals.lww.com", "url": "https://journals.lww.com/ijo/_layouts/15/oaks.journals/downloadpdf.aspx?an=02223307-990000000-00389", "authors": "journals.lww.com", "host": "journals.lww.com" }, { "number": 7, "title": "Vitreous substitutes and tamponades – A review of types,... : Indian Journal of Ophthalmology", "detail": "journals.lww.com", "url": "https://journals.lww.com/ijo/fulltext/2024/72080/vitreous_substitutes_and_tamponades___a_review_of.6.aspx", "authors": "journals.lww.com", "host": "journals.lww.com" }, { "number": 8, "title": "Silicone oil emulsification in the anterior chamber after vitreoretinal surgery - ScienceDirect", "detail": "www.sciencedirect.com", "url": "https://www.sciencedirect.com/science/article/abs/pii/S1529183906003964", "authors": "www.sciencedirect.com", "host": "www.sciencedirect.com" }, { "number": 9, "title": "The downside of tamponade: Silicone oil emulsification and its ocular impact - ScienceDirect", "detail": "www.sciencedirect.com", "url": "https://www.sciencedirect.com/science/article/abs/pii/S0039625725002292", "authors": "www.sciencedirect.com", "host": "www.sciencedirect.com" }, { "number": 10, "title": "Vitreoretinal Surgery - an overview | ScienceDirect Topics", "detail": "www.sciencedirect.com", "url": "https://www.sciencedirect.com/topics/medicine-and-dentistry/vitreoretinal-surgery", "authors": "www.sciencedirect.com", "host": "www.sciencedirect.com" }, { "number": 11, "title": "Effect of perfluoropropane (C3F8) versus sulfurhexafluoride (SF6) tamponades on the retinal microvasculature after macular hole surgery - ScienceDirect", "detail": "www.sciencedirect.com", "url": "https://www.sciencedirect.com/science/article/abs/pii/S1572100023005744", "authors": "www.sciencedirect.com", "host": "www.sciencedirect.com" }, { "number": 12, "title": "Agents for Vitreous Tamponade - StatPearls - NCBI Bookshelf - NIH", "detail": "www.ncbi.nlm.nih.gov", "url": "https://www.ncbi.nlm.nih.gov/books/NBK580519", "authors": "www.ncbi.nlm.nih.gov", "host": "www.ncbi.nlm.nih.gov" }, { "number": 13, "title": "Tamponade in surgery for retinal detachment associated with proliferative vitreoretinopathy - Schwartz, SG - 2020 | Cochrane Library", "detail": "www.cochranelibrary.com", "url": "https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD006126.pub4/references", "authors": "www.cochranelibrary.com", "host": "www.cochranelibrary.com" }, { "number": 14, "title": "In Memory of J. 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Use of radical dissection of the vitreous base and perfluoro-octane and intraocular tamponade - PubMed", "detail": "www.ncbi.nlm.nih.gov", "url": "https://www.ncbi.nlm.nih.gov/pubmed/1584565", "authors": "www.ncbi.nlm.nih.gov", "host": "www.ncbi.nlm.nih.gov" }, { "number": 21, "title": "Clinical complications of Densiron 68 intraocular tamponade for complicated retinal detachment | Eye", "detail": "www.nature.com", "url": "https://www.nature.com/articles/eye200957", "authors": "www.nature.com", "host": "www.nature.com" }, { "number": 22, "title": "Evaluation of long-term outcomes associated with extended heavy-silicone oil use for the treatment of inferior retinal detachment | Scientific Reports", "detail": "www.nature.com", "url": "https://www.nature.com/articles/s41598-022-15896-y", "authors": "www.nature.com", "host": "www.nature.com" }, { "number": 23, "title": "Pars Plana Vitrectomy With Silicone Oil or Gas Tamponade for Uncomplicated Retinal Detachment: A Systematic Review and Meta-Analysis", "detail": "www.sciencedirect.com", "url": "https://www.sciencedirect.com/science/article/pii/S0002939424002095", "authors": "www.sciencedirect.com", "host": "www.sciencedirect.com" }, { "number": 24, "title": "Pharmacological agents for treatment of proliferative vitreoretinopathy: A systematic review and network meta-analysis - ScienceDirect", "detail": "www.sciencedirect.com", "url": "https://www.sciencedirect.com/science/article/abs/pii/S0039625725000335", "authors": "www.sciencedirect.com", "host": "www.sciencedirect.com" } ], "editorialNote": "Prepared from cited clinical literature using Astra's research workflow. Verify recommendations against current guidance and patient-specific factors.", "citations": [ { "number": 1, "title": "Silicone Oil Applications in Vitreoretinal Surgery - Nature", "detail": "www.nature.com", "url": "https://www.nature.com/nature-index/topics/l4/silicone-oil-applications-in-vitreoretinal-surgery", "authors": "www.nature.com", "host": "www.nature.com", "snippet": "Silicone oil serves as a long-term internal tamponade agent in vitreoretinal surgery, primarily for rhegmatogenous retinal detachment and proliferative vitreoretinopathy. Its physical properties—including viscosity, density and interfacial tension—allow displacement of intraocular fluids and mainten", "score": 0.72254705 }, { "number": 2, "title": "Thirteen year experience of vitrectomy and air tamponade for primary retinal detachment repair with clinical outcomes | Scientific Reports", "detail": "www.nature.com", "url": "https://www.nature.com/articles/s41598-024-79889-9", "authors": "www.nature.com", "host": "www.nature.com", "snippet": "Tamponade agents aim to create surface tension across retinal breaks, preventing further fluid entry into the subretinal space until retinopexy (photocoagulation or cryopexy) establishes a permanent seal. The most commonly used tamponades are sulfur hexafluoride (SF6), perfluoropropane (C3F8), and s", "score": 0.62358373 }, { "number": 3, "title": "Biocompatibility of intraocular liquid tamponade agents: an update | Eye", "detail": "www.nature.com", "url": "https://www.nature.com/articles/s41433-021-01596-w", "authors": "www.nature.com", "host": "www.nature.com", "snippet": "Intraocular liquids tamponade agents, such as perfluorocarbon liquids (PFCLs), semifluorinated alkanes (SFAs), silicone oils (SOs) and heavy silicone oils (HSOs), are a crucial intraoperative and/or postoperative tool in vitreoretinal surgery, in particular for the management of complex vitreoretina", "score": 0.5717911 }, { "number": 4, "title": "A new heavy internal tamponade in vitreoretinal surgery: an in vitro study | Eye", "detail": "www.nature.com", "url": "https://www.nature.com/articles/eye2008144", "authors": "www.nature.com", "host": "www.nature.com", "snippet": "Chapter \nGoogle Scholar\n\nSharma T, Gopal L, Shanmugam MP, Bhende PS, Agrawal R, Badrinath SS et al. Management of recurrent retinal detachment in silicone oil-filled eyes. Retina 2002; 22: 153–157.\n\nArticle \nGoogle Scholar\n\nFalkner CI, Binder S, Kruger A . Outcome after silicone oil removal. Br J Op", "score": 0.43597415 }, { "number": 5, "title": "Silicone oil in vitreoretinal surgery: indications, complications, new developments and alternative long‐term tamponade agents - Chen - 2021 - Acta Ophthalmologica - Wiley Online Library", "detail": "onlinelibrary.wiley.com", "url": "https://onlinelibrary.wiley.com/doi/10.1111/aos.14604", "authors": "onlinelibrary.wiley.com", "host": "onlinelibrary.wiley.com", "snippet": "The published literature articles were searched using PubMed with the following keywords: silicone oil, properties of silicone oil, emulsification, tamponade, risk factors, vitreoretinal surgery, retinal detachment, removal of silicone oil and vitreous substitute. Silicone oil (SO) is also used to t", "score": 0.76279575 }, { "number": 6, "title": "Management of retinal detachment and myopia –... : Indian Journal of Ophthalmology", "detail": "journals.lww.com", "url": "https://journals.lww.com/ijo/_layouts/15/oaks.journals/downloadpdf.aspx?an=02223307-990000000-00389", "authors": "journals.lww.com", "host": "journals.lww.com", "snippet": "Tamponade agents are used to provide surface tension across retinal breaks preventing fluid flow into the subretinal space until chorioretinal adhesion forms from the retinopexy. Nonexpansile gas (20% SF6 and 14% C3F8) and silicon oil (1000 cst and 5000 cst) are the commonly preferred tamponading ag", "score": 0.75659186 }, { "number": 7, "title": "Vitreous substitutes and tamponades – A review of types,... : Indian Journal of Ophthalmology", "detail": "journals.lww.com", "url": "https://journals.lww.com/ijo/fulltext/2024/72080/vitreous_substitutes_and_tamponades___a_review_of.6.aspx", "authors": "journals.lww.com", "host": "journals.lww.com", "snippet": "Vitrectomy with silicone oil or sulfur hexafluoride gas in eyes with severe proliferative vitreoretinopathy: Results of a randomized clinical trial. Silicone Study Report 1. Arch Ophthalmol 1992;110:770–9.Cited HereCrossRefPubMedGoogle Scholar \n ## 40.\n\nRush RB, Del Valle Penella A, Reinauer RM, R", "score": 0.71995544 }, { "number": 8, "title": "Silicone oil emulsification in the anterior chamber after vitreoretinal surgery - ScienceDirect", "detail": "www.sciencedirect.com", "url": "https://www.sciencedirect.com/science/article/abs/pii/S1529183906003964", "authors": "www.sciencedirect.com", "host": "www.sciencedirect.com", "snippet": "### Based on reading popularity\n\n## Cited by (22)\n\nCurrently, the most used long-term vitreous substitute in clinical practice is silicone oil. However, silicone oil has the disadvantages of emulsification, complications and the requirement to be removed by a second surgery, which limit the potentia", "score": 0.7018975 }, { "number": 9, "title": "The downside of tamponade: Silicone oil emulsification and its ocular impact - ScienceDirect", "detail": "www.sciencedirect.com", "url": "https://www.sciencedirect.com/science/article/abs/pii/S0039625725002292", "authors": "www.sciencedirect.com", "host": "www.sciencedirect.com", "snippet": "### Clin Microbiol Infect\n\n### Heavy silicone oil tamponade in retinal detachment surgery: a systematic review and single-arm meta-analysis on Densiron 68 and Oxane HD\n\n### AJO Int\n\n### Prone CT for diagnosis of silicone oil intraventricular migration after intraocular tamponade\n\n### Radio Case Rep\n", "score": 0.6407488 }, { "number": 10, "title": "Vitreoretinal Surgery - an overview | ScienceDirect Topics", "detail": "www.sciencedirect.com", "url": "https://www.sciencedirect.com/topics/medicine-and-dentistry/vitreoretinal-surgery", "authors": "www.sciencedirect.com", "host": "www.sciencedirect.com", "snippet": "Over the first three decades of its history, advances in vitreoretinal surgery were dependent upon improvements in microsurgical instrumentation to facilitate removal of the vitreous gel and epiretinal membranes. Advances in vitreous surgery involved the development of intraocular tamponade such as ", "score": 0.59372765 }, { "number": 11, "title": "Effect of perfluoropropane (C3F8) versus sulfurhexafluoride (SF6) tamponades on the retinal microvasculature after macular hole surgery - ScienceDirect", "detail": "www.sciencedirect.com", "url": "https://www.sciencedirect.com/science/article/abs/pii/S1572100023005744", "authors": "www.sciencedirect.com", "host": "www.sciencedirect.com", "snippet": "### The multifunctional choroid\n\n### Prog. Retin. Eye Res.\n\n### Clinicopathologic correlation of a macular hole treated by cortical vitreous peeling and gas tamponade\n\n### Ophthalmology\n\n### Idiopathic senile macular hole. Its early stages and pathogenesis\n\n### Arch. Ophthalmol.\n\n### Anomalous poste", "score": 0.3899187 }, { "number": 12, "title": "Agents for Vitreous Tamponade - StatPearls - NCBI Bookshelf - NIH", "detail": "www.ncbi.nlm.nih.gov", "url": "https://www.ncbi.nlm.nih.gov/books/NBK580519", "authors": "www.ncbi.nlm.nih.gov", "host": "www.ncbi.nlm.nih.gov", "snippet": "ix) Internal limiting membrane (ILM) peeling: It serves as a surgical third hand and helps in ILM peeling during the surgery, especially in eyes with RRD and advanced diabetes. Also, ILM gets easily stained under PFCL.\n\nx) Induction of PVD (posterior vitreous detachment): It can be used to induce PV", "score": 0.6565047 }, { "number": 13, "title": "Tamponade in surgery for retinal detachment associated with proliferative vitreoretinopathy - Schwartz, SG - 2020 | Cochrane Library", "detail": "www.cochranelibrary.com", "url": "https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD006126.pub4/references", "authors": "www.cochranelibrary.com", "host": "www.cochranelibrary.com", "snippet": "Title: Tamponade in surgery for retinal detachment associated with proliferative vitreoretinopathy - Schwartz, SG - 2020 | Cochrane Library\nOpens in a new window Opens an external website Opens an external website in a new window. This website utilizes technologies such as cookies to enable essentia", "score": 0.6326168 }, { "number": 14, "title": "In Memory of J. Donald M. Gass (1928–2005) - Ophthalmology", "detail": "www.aaojournal.org", "url": "https://www.aaojournal.org/article/S0161-6420(05)00597-X/fulltext", "authors": "www.aaojournal.org", "host": "www.aaojournal.org", "snippet": "Gass, Harry Flynn, a long-time colleague on the Bascom Palmer Eye Institute faculty of Dr Gass, told the audience that “Don described it first and described it best.” Harry listed a series of important first descriptions of various retinal diseases of Don’s. * Macular Hole Closure by Internal Limiti", "score": 0.55709904 }, { "number": 15, "title": "Vitreous substitutes and tamponades – A review of types, applications, and future directions - PMC", "detail": "pmc.ncbi.nlm.nih.gov", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC11451774", "authors": "pmc.ncbi.nlm.nih.gov", "host": "pmc.ncbi.nlm.nih.gov", "snippet": "Comparison of various intravitreal gases can be\n\n| Intravitreal gases | | Duration of action | | 100% gas expansion duration | | Isoexpansile concentration |\n --- --- --- \n| Perfluoropropane C3F8 | | Long-acting | | 7.6 days | | 14% |\n| Perfluoroethane C2F6 | | Medium acting | | 3.5 days |", "score": 0.5971152 }, { "number": 16, "title": "Tamponade in the surgical management of retinal detachment", "detail": "pmc.ncbi.nlm.nih.gov", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC4801126", "authors": "pmc.ncbi.nlm.nih.gov", "host": "pmc.ncbi.nlm.nih.gov", "snippet": "### Properties and characteristics of commonly used agents\n\nThe most common gas tamponades used in the USA are air, SF 6, and perfluoropropane (C 3 F 8) (Figure 1).14 In some centers, perfluoroethane (C 2 F 6) is used. Air is nonexpansile, while 100% SF 6 expands approximately two times over 1–2 day", "score": 0.5515985 }, { "number": 17, "title": "Tamponade or Filling Effect: Changes of Forces in Myopic Eyes - PMC", "detail": "pmc.ncbi.nlm.nih.gov", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC4101978", "authors": "pmc.ncbi.nlm.nih.gov", "host": "pmc.ncbi.nlm.nih.gov", "snippet": "Here, we outline the main characteristics of the endotamponade agents used today in vitreoretinal surgery. Current vitreous substitutes are primarily categorized on the basis of the duration of the tamponade effect, either short term, such as with various gases, or permanent, such as with silicone o", "score": 0.4993414 }, { "number": 18, "title": "Incidence and Risk Factors of Elevated Intraocular Pressure Following Vitrectomy Surgery in Rhegmatogenous Retinal Detachment in a Tertiary Hospital in Northern Malaysia - PMC", "detail": "pmc.ncbi.nlm.nih.gov", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC12790704", "authors": "pmc.ncbi.nlm.nih.gov", "host": "pmc.ncbi.nlm.nih.gov", "snippet": "Although gender showed an association in the earlier chi-square analysis, which corresponds with Pillai et al. , this did not persist after adjustment, suggesting that the initial finding may have been confounded by other factors. Our findings did not show significant differences between 23G and 25G", "score": 0.43323857 }, { "number": 19, "title": "Tamponade in the surgical management of retinal detachment - PMC", "detail": "www.ncbi.nlm.nih.gov", "url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4801126", "authors": "www.ncbi.nlm.nih.gov", "host": "www.ncbi.nlm.nih.gov", "snippet": "Cataract formation is also another common complication associated with both gas and silicone oil tamponade, with reported rates of up to 100%.45 Venous air embolization secondary to fluid–air exchange during vitrectomy has been simulated in donor eyes46 following three separately published cases (on", "score": 0.60077465 }, { "number": 20, "title": "Management of giant retinal tears without scleral buckling. Use of radical dissection of the vitreous base and perfluoro-octane and intraocular tamponade - PubMed", "detail": "www.ncbi.nlm.nih.gov", "url": "https://www.ncbi.nlm.nih.gov/pubmed/1584565", "authors": "www.ncbi.nlm.nih.gov", "host": "www.ncbi.nlm.nih.gov", "snippet": "Title: Management of giant retinal tears without scleral buckling. Use of radical dissection of the vitreous base and perfluoro-octane and intraocular tamponade - PubMed\nAn official website of the United States government. **The .gov means it’s official.**. Federal government websites often end in .", "score": 0.39873472 }, { "number": 21, "title": "Clinical complications of Densiron 68 intraocular tamponade for complicated retinal detachment | Eye", "detail": "www.nature.com", "url": "https://www.nature.com/articles/eye200957", "authors": "www.nature.com", "host": "www.nature.com", "snippet": "Article \nCAS \nGoogle Scholar\n\nFlindall RJ, Norton EW, Curtin VT, Gass JD . Reduction of extrusion and infection following episcleral silicone implants and cryopexy in retinal detachment surgery. Am J Ophthalmol 1971; 71 (4): 835–837.\n\nArticle \nCAS \nGoogle Scholar\n\nKwartz J, Charles S, McCormack P, J", "score": 0.38887385 }, { "number": 22, "title": "Evaluation of long-term outcomes associated with extended heavy-silicone oil use for the treatment of inferior retinal detachment | Scientific Reports", "detail": "www.nature.com", "url": "https://www.nature.com/articles/s41598-022-15896-y", "authors": "www.nature.com", "host": "www.nature.com", "snippet": "until the removal of these tamponades22.\"). The higher rate of emulsification compared to the literature may be the result of long-term presence of HSO in the eye. Due to emulsified silicone oil droplets in one patient, vitreous cavity was cleaned using a perfluorobutylpentane (F4H5) solvent-assiste", "score": 0.3410561 }, { "number": 23, "title": "Pars Plana Vitrectomy With Silicone Oil or Gas Tamponade for Uncomplicated Retinal Detachment: A Systematic Review and Meta-Analysis", "detail": "www.sciencedirect.com", "url": "https://www.sciencedirect.com/science/article/pii/S0002939424002095", "authors": "www.sciencedirect.com", "host": "www.sciencedirect.com", "snippet": "Systematic review and meta-analysis.\n\n### Methods\n\nA systematic literature search was conducted on Ovid MEDLINE, Embase, and the Cochrane Library from January 2000 to September 2023 for comparative studies evaluating the efficacy and safety of PPV with either silicone oil or gas tamponade in the set", "score": 0.6922474 }, { "number": 24, "title": "Pharmacological agents for treatment of proliferative vitreoretinopathy: A systematic review and network meta-analysis - ScienceDirect", "detail": "www.sciencedirect.com", "url": "https://www.sciencedirect.com/science/article/abs/pii/S0039625725000335", "authors": "www.sciencedirect.com", "host": "www.sciencedirect.com", "snippet": "### Stat Med\n\n### Prevention of second primary tumors with isotretinoin in squamous-cell carcinoma of the head and neck\n\n### N Engl J Med\n\n## Cited by (6)\n\n### Intravitreal nintedanib attenuates proliferative vitreoretinopathy in a mouse model: Efficacy, safety, and mechanistic insights\n\n### N6-meth", "score": 0.62303346 } ], "publishedAt": "2026-09-15T22:24:55.657739+00:00", "updatedAt": "2026-09-15T22:24:55.657739+00:00", "readingMinutes": 7, "slug": "agents-for-vitreous-tamponade" }