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J.D. Luna, M.B. Yadarola, P. Arrambide, L.J. Caribaux, M.C. Raffaini, V.E. Reviglio, C.P. Juarez; Perfluorocarbon liquid vitreous delamination and wide– angle viewing systems in the management of complicated diabetic retinal detachment. . Invest. Ophthalmol. Vis. Sci. 2004;45(13):2016.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: Perfluorocarbon liquids and wide–angle viewing systems represent major advances in vitreoretinal surgery. Vitreous surgery has become the standard treatment for blinding complications of fibrovascular tissue growth in patients with proliferative diabetic retinopathy (PDR). We used perfluorocarbo–n–octano and a wide–angle viewing system in the management of 76 cases of tractional and combined tractional/rhegmatogenous retinal detachment secondary to proliferative diabetic retinopathy. Methods: The 'en bloc' excision technique using the wide–angle observation system and the delamination with perfluorocarbon liquid was used in 76 consecutive cases of severe proliferative diabetic retinopathy with tractional and combined tractional/rhegmatogenous retinal detachment between July 1998 and December 2002. All eyes had extensive fibrovascular proliferative membranes resulting in tractional elevation of the retina. None of them had undergone previous photocoagulation. Linear regression analysis was used to compare the preoperative visual acuity with the final visual acuity. Preooperative characteristics, intraoperative findings, procedures and postoperative results were recorded. Results: After 6 months to 4 years of follow–up, visual acuity > or = 20/40 was 3 (3.95%) preoperatively and 11 (14.47%) postoperatively; visual acuity of 20/50 to 20/200 was 12 (15.79%) preop. and 7 (9.21%) postop.; and visual acuity < or = 20/400 was 61 (80.26%) and 58 (76.31%) preop. and postop. respectively. The mean final visual acuity was log mar 1.2 before surgery and 0.89 after vitrectomy with a P–value of 0.001. Conclusions: In our experience, perfluorocarbo–n–octano and a wide–angle viewing system in the management of complicated cases of tractional and combined tractional/rhegmatogenous retinal detachment secondary to proliferative diabetic retinopathy can be considered a very good alternative to improve visual acuity.
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