Abstract
Purpose: :
double filling with perfluoro-n-octane (n-C8F18) and polydimethyloxane (PDMS) has already been used in human eyes as temporary vitreous substitute after pars plana vitrectomy (PPV) in selected cases of retinal detachment. This in order to fill the vitreous cavity completely, reducing empty spaces, limiting the concentration of substances useful to proliferative vitreoretinopathy (PVR) development and limiting mechanically the contraction of membranes with consequent retinal detachment relapse. The aim of this study is to evaluate its ocular tolerance and efficacy.
Methods: :
in 30 eyes of 30 patients, after PPV, double-filling with 30% n-C8F18 and 70% PDMS was maintained for an average of 23 days and successively exchanged with BSS, air or PDMS. Main outcome measures were visual acuity (VA), intraocular pressure (IOP), PVR reproliferation and electrophysiology parameters (ERG B uV, bf ERG).
Results: :
three months after double filling removal, 14 patients (46.7%) had postoperative VA improvement, 12 patients (40.4%) maintained their preoperative VA, 4 of them (13.3%) experienced a reduction of VA. The postoperative IOP average was 19.7 mmHG (range: 11-32 mmHG), nine eyes (30%) developed IOP increase treated with with topical drops and/or systemic carbonic anydrase inhibitors. Three patients (10.0%) developed new PVR, two of them in the superior sectors, the other one inferiorly. BuV ERG and bf ERG parameters recorded in 20 cases showed a statistically significant improvement.
Conclusions: :
our experience with double filling in selected cases of retinal detachment has been positive, with no electrophysiology signs of retinal toxicity and a low incidence of PVR reproliferation.
Keywords: vitreous substitutes • retinal detachment • proliferative vitreoretinopathy