Clinical Implications of heavy silicon oil (Densiron®) endotamponade after pars plana vitrectomy: A systematic review and meta-analysis

Rhegmatogenous retinal detachments (RRDs) with inferior retinal breaks (IRBs) pose significant surgical challenges, lacking a universally accepted treatment standard. Heavy silicone oils (HSOs), specifically Densiron® 68 and Densiron XTRA, have emerged as promising endotamponade agents because of their specific gravity, which is greater than that of water, allowing effective tamponade in the inferior retina. Unlike earlier HSO formulations, these newer variants show reduced rates of intraocular inflammation while maintaining favorable anatomical outcomes, even when compared with concomitant scleral buckle (SB) use; however, their usage remains limited, particularly in the U.S. This systematic review assessed clinical indications, anatomical reattachment rates, and intraocular inflammation linked to Densiron 68 and Densiron XTRA. A comprehensive search of Ovid MEDLINE, EMBASE, and Cochrane CENTRAL identified 616 references, of which 22 studies involving 970 eyes met the inclusion criteria. Pooled analyses revealed a 16.7% rate of oil dispersion and emulsification, 13.0% incidence of intraocular inflammation, and 7.1% occurrence of oil migration into the anterior chamber. Notably, anatomical retinal reattachment following endotamponade removal was achieved in 80.1% of cases. These findings underscore the efficacy of Densiron 68 and Densiron XTRA in managing complex primary and secondary RRDs, offering a potentially viable solution with lower complication rates than prior HSOs. Their demonstrated success in achieving high anatomical reattachment rates positions them as promising tools in advancing RRD treatment.