April 2014
Volume 55, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2014
Outcomes of Sustained Perfluoro-n-octane Tamponade for Retinal Detachment Associated with Giant Retinal Tear
Author Affiliations & Notes
  • Dustin Pomerleau
    Medical Retina & Vitreoretinal Surgery, Retina Center of Maine, Portland, ME
  • Mei Hong Tan
    Department of Ophthalmology, Royal Perth Hospital, Perth, WA, Australia
    Centre for Ophthalmology and Visual Science, Lions Eye Institute, Perth, WA, Australia
  • Jane Huan-Ling Lock
    Department of Ophthalmology, Royal Perth Hospital, Perth, WA, Australia
  • Timothy Isaacs
    Department of Ophthalmology, Royal Perth Hospital, Perth, WA, Australia
    Centre for Ophthalmology and Visual Science, Lions Eye Institute, Perth, WA, Australia
  • Ian McAllister
    Department of Ophthalmology, Royal Perth Hospital, Perth, WA, Australia
    Centre for Ophthalmology and Visual Science, Lions Eye Institute, Perth, WA, Australia
  • Footnotes
    Commercial Relationships Dustin Pomerleau, None; Mei Hong Tan, None; Jane Huan-Ling Lock, None; Timothy Isaacs, None; Ian McAllister, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science April 2014, Vol.55, 1110. doi:https://doi.org/
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      Dustin Pomerleau, Mei Hong Tan, Jane Huan-Ling Lock, Timothy Isaacs, Ian McAllister; Outcomes of Sustained Perfluoro-n-octane Tamponade for Retinal Detachment Associated with Giant Retinal Tear. Invest. Ophthalmol. Vis. Sci. 2014;55(13):1110. doi: https://doi.org/.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: To evaluate outcomes and potential complications of sustained tamponade with perfluoro-n-octane (PFO) in retinal detachment cases involving giant retinal tears (GRT).

Methods: 168 charts from 2 centers were retrospectively reviewed, and cases involving sustained PFO tamponade were evaluated for inclusion. 26 eyes met inclusion criteria, with a primary diagnosis of rhegmatogenous retinal detachment, presence of a GRT (≥ 3 clock hours), and 12 months of follow-up. Treatment consisted of a primary vitrectomy, PFO tamponade and endolaser followed by post-operative predominantly supine positioning. Patients were evaluated at 1 week and 1, 3, 6, and 12 months. Primary treatment success was defined as anatomical attachment at 12 months without need for additional surgery after PFO removal.

Results: Mean presenting visual acuity (VA) for patients with quantifiable vision was 0.40 logMAR, with 13 (50%) presenting macula-on and 13 (50%) presenting macula-off. 18 Eyes were phakic, 7 were pseudophakic and 1 was aphakic. 20 (77%) eyes had GRTs involving inferior quadrants, and 6 (23%) had superior GRTs not extending below the horizontal meridian. The surgical procedure was 20 gauge in 11 (42%) cases and 25 gauge in 15 (58%) cases, and was combined with encircling scleral buckle in 5 (19%) cases. PFO was left in-situ for a mean of 7 days (range 4-18 days). PFO was exchanged for SF6 in 17 (65%) eyes, C3F8 in 5 (19%) eyes, and silicone oil in 4 (15%) eyes. Over 12 months, the primary success rate was 85%, with 4 eyes requiring additional surgery for persistent/recurrent detachment. Mean VA at 1, 3, 6, and 12 months was 0.52, 0.48, 0.73, and 0.55 logMAR, respectively. Associated findings and adverse events included anterior chamber inflammation in 3 (12%) eyes, IOP elevation (> 22 mm Hg) in 6 (23%) eyes, epiretinal membrane sufficient to warrant surgery in 2 (8%) eyes, prolapse of PFO into the anterior chamber in 1 (4%) eye, and progression of nuclear sclerosis sufficient to warrant cataract surgery in 9 (35%) eyes. Subretinal PFO was not identified in any of the study eyes. There were no instances of retinal slippage.

Conclusions: Short-term (1-2 week) tamponade with PFO is an effective treatment strategy in retinal detachments associated with giant retinal tear. Careful patient selection and close follow-up are required to mitigate potential adverse events.

Keywords: 697 retinal detachment • 764 vitreous substitutes • 688 retina  
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