Abstract
Purpose :
Short term endotamponade with perfluprocarbon liquids (PFCL) is used as a surgical technique in treatment of certain vitreoretinal conditions. Controversy exists around its safety, as cases of retinal toxicity and inflammation were described. We present indications for use and results of short term endotamponade with a PFCL, perfluoro-N-octane (PFO) in treating surgical retinal pathology at Sydney and Sydney Eye Hospital (SSEH)
Methods :
A retrospective case series of 42 eyes of 42 patients (31 male, 11 female, 10- 87 yr, mean:55.4 yr) who underwent vitrectomy with short term PFO endotamponade at SSEH between September 2019 and June 2021. Patients consented to data use, and their medical records were reviewed retrospectively. We recorded presenting diagnosis, pre-operative best-corrected visual acuity (BCVA), duration of PFO endotamponade, type of subsequent endotamponade used, additional surgeries, complications and final BCVA. Statistical analysis was carried out using R: A Language and Environment for Statistical Computing, version 4.0.5, R Core Team, R Foundation for Statistical Computing, Vienna, Austria.
Results :
Preoperative BCVA was available in 37cases (mean:1.42logMAR). Indications included: giant retinal tear (GRT) (n=18); recurrent retinal detachment (RD)(n=7), RD with large or multiple breaks(n=5); penetrating eye injury (n=3). PFO was removed after 3-21days (mean:8.9days) and exchanged to long-acting gas in 58%(100%GRTs). Mean follow-up:177,3 days. Complications included: recurrent RD: n=3, cataract: n=7, significant epiretinal membrane: n=8 (5/8 in recurrent RD), macular oedema: n=7 (5/7 in recurrent RD), PFO in the anterior chamber: n=5, intraocular inflammation: n=2. We did not observe retinal toxicity. Mean final BCVA was 0.85logMAR overall and 0.40logMAR in the GRT group. Where preoperative data was available mean BCVA improved by 0.54logMAR. Visual improvement: 70.3%, deterioration:18.9%. Final BCVA was positively correlated with initial BCVA (p <0.001). Diagnosis was significantly differentiating final BCVA (p=0.001).There was no significant correlation between final BCVA and duration of tamponade (p=0.637).
Conclusions :
Short-term tamponade with PFO provides good anatomical and functional outcomes and can be safely used in selected cases. The final result depends on the complexity of the underlying pathology and initial BCVA, not length of the tamponade.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.