PURPOSE: Thanks to their physical properties, could perfluorocarbon liquids (PFCL) be useful during vitrectomy for severe cases of proliferative diabetic vitreo-retinopathy (PDVR)? METHODS: Among 120 vitrectomies for PDVR performed in a period of time from August 1992 to July 1993, we reviewed 24 cases with a minimal follow-up of six months for which we have used PFCL as intraoperative tool. Among these eyes, three (12%) were preoperatively attached, seven (29%) presented with a tractional retinal detachment sparing the macular area and 14 (59%) with a retinal detachment involving the macula. The indication for PFCL injection was either to flatten the retina in case of iatrogenic tear or retinotomy (15/24 eyes) or to stop a bleeding coming from the optic disc (9/24). The aim was to allow a good laser endophotocoagulation in all the cases and to inject an intraocular tamponade on a reattached retina if needed. As final tamponade, silicone oil was used in 10 eyes, gas in nine eyes and none in five eyes. RESULTS: At the end of the study, 20 (83%) eyes had a totally reattached retina and four (17%) a detached retina. The postoperative compared to the preoperative visual acuity was improved in 13 eyes (54%), unchanged in seven eyes (30%) and decreased in four eyes (16%). In one case (4%), some droplets of PFCL were noticed in the vitreous cavity, under the silicone oil bubble, with a good clinical tolerance. No specific complication of PFCL injection could be found in the 23 other eyes. CONCLUSION: In some selected cases of severe PDVR, the use of PFCL may help to flatten the retina, to stop bleeding from the optic disc and to perform a good endolaser photocoagulation. This allows to achieve good anatomical and visual results with few specific complications.
PURPOSE: Thanks to their physical properties, could perfluorocarbon liquids (PFCL) be useful during vitrectomy for severe cases of proliferative diabetic vitreo-retinopathy (PDVR)? METHODS: Among 120 vitrectomies for PDVR performed in a period of time from August 1992 to July 1993, we reviewed 24 cases with a minimal follow-up of six months for which we have used PFCL as intraoperative tool. Among these eyes, three (12%) were preoperatively attached, seven (29%) presented with a tractional retinal detachment sparing the macular area and 14 (59%) with a retinal detachment involving the macula. The indication for PFCL injection was either to flatten the retina in case of iatrogenic tear or retinotomy (15/24 eyes) or to stop a bleeding coming from the optic disc (9/24). The aim was to allow a good laser endophotocoagulation in all the cases and to inject an intraocular tamponade on a reattached retina if needed. As final tamponade, silicone oil was used in 10 eyes, gas in nine eyes and none in five eyes. RESULTS: At the end of the study, 20 (83%) eyes had a totally reattached retina and four (17%) a detached retina. The postoperative compared to the preoperative visual acuity was improved in 13 eyes (54%), unchanged in seven eyes (30%) and decreased in four eyes (16%). In one case (4%), some droplets of PFCL were noticed in the vitreous cavity, under the silicone oil bubble, with a good clinical tolerance. No specific complication of PFCL injection could be found in the 23 other eyes. CONCLUSION: In some selected cases of severe PDVR, the use of PFCL may help to flatten the retina, to stop bleeding from the optic disc and to perform a good endolaser photocoagulation. This allows to achieve good anatomical and visual results with few specific complications.