Pars plana vitrectomy with medium-term perfluoro-n-octane (PFO) for severe proliferative diabetic retinopathy (PDR) with traction retinal detachment (TRD)

Abstract

Purpose: To study a retrospective series of patients with TRD which had severe transoperative bleeding treated with pars plana vitrectomy (PPV) and post operative medium-term tamponade with perfluoro-n-octane (PFO).

Methods: 5 eyes of 5 patients were considered in this retrospective study. Inclusion criteria were patients with severe PDR and TRD in which PFO was used as a medium-term tamponade. All patients received a 23-gauge PPV with tamponade with PFO for a mean of 4 weeks, with planned removal of PFO in a second scheduled surgery. After removing the PFO all patients received 1000 centistoke Silicone Oil.

Results: Mean follow-up time was 6 months +/- 2 months. All patients had improved final BCVA which was light perception before the surgery , and post operatively all patients achieved count finger vision or better. All patients also had active hemorrhage during the PPV procedure. All patients had some degree of anterior segment inflammation during PFO tamponade. Hemorrhage resolved in all patients . In addition, during PFO tamponade, all patients had a transient rise in intraocular pressure (IOP) above 21 mm Hg which was controlled with topical medication

Conclusions: Medium-term PFO was found to be useful on the treatment of active hemorrhage on eyes having severe PDR and TRD. PFO allowed stabilization on proliferative status and subsequent silicone oil long-term tamponade.

Keywords: 762 vitreoretinal surgery • 764 vitreous substitutes