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J.C. Law, A. Tewari, D. Eliott; Use of Perfluorocarbon Liquid During Diabetic Vitrectomy . Invest. Ophthalmol. Vis. Sci. 2005;46(13):5498.
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Purpose: The use of perfluorocarbon liquid (PFCL) has facilitated the treatment of complex retinal detachments. The purposes of this study were to evaluate the indications for PFCL use and the anatomic and functional outcome after PFCL use during pars plana vitrectomy (PPV) for proliferative diabetic retinopathy (PDR). Methods: Retrospective review of 534 consecutive diabetic vitrectomies done by one vitreoretinal surgeon at Kresge Eye Institute was performed. PFCL was used in 31 of these cases. Preoperative visual acuity, type of retinal detachment, and indication for PFCL were assessed. Final visual acuity and anatomical results at most recent follow up visit were recorded. Results: Of 31 eyes undergoing vitrectomy with PFCL for PDR, 23 of these were entered into the study. The remaining 8 eyes were not studied due to insufficient data. Among the studied eyes, 13 underwent primary vitrectomy, while 10 were re–operations for recurrent retinal detachment secondary to proliferation. The preoperative visual acuity for primary vitrectomies ranged from 20/200 to light perception (LP), while preoperative acuity for re–operations ranged from 20/100 to LP. Among the 13 primary vitrectomies, 12 had detached maculas; 8 were combined tractional and rhegmatogenous detachments with peripheral retinal hole(s), while 5 were severe tractional retinal detachments with iatrogenic peripheral retinal hole(s). None of these cases had posterior retinal holes. PFCL facilitated flattening in these complicated detachments and enabled drainage of subretinal fluid. All twenty–three eyes achieved anatomical flattening (mean follow up time 26.2 months). Postoperative complications included 1 patient who developed persistent hypotony and three patients who developed neovascular glaucoma. Conclusions: Retinal detachments in proliferative diabetic retinopathy represent advanced disease and PFCL may be used as an adjunct to achieve flattening. PFCL is beneficial in cases with pre–existing or iatrogenic peripheral retinal holes in the absence of a posterior hole.
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