Management of Giant Retinal Tears Using Perfluorodecalin as a Postoperative Short-Term Vitreoretinal Tamponade: A Long-Term Follow-Up Study

Abstract

To avoid postoperative "compartmentalization" of the vitreous cavity, which may accelerate the recurrence of proliferative vitreoretinopathy (PVR), and to provide a tamponading effect lasting long enough to allow the formation of a firm chorioretinal adhesion by retinopexy, we managed 11 eyes with giant retinal tears and grade-B PVR with lensectomy, vitrectomy, 5-day internal tamponade with perfluorodecalin (PFD), and postoperative supine positioning until the PFD was removed. Baseline characteristics included myopia (10 eyes; range, 5.00 to 15.00 diopters) and perforating trauma (one eye). All patients underwent PFD/fluid exchange 5 days after surgery. Anatomic attachment of the retina was achieved with two operations (the second one being the removal of the PFD) in 9 (82%) of the 11 eyes (median follow up, 18 months). In eight eyes (73%), there was no evidence of reproliferation; in one (successfully reattached after PFD/fluid exchange), a macular pucker developed. The intraocular PFD used as an internal tamponade appeared to be well tolerated for up to 5 days, as judged by static threshold perimetry in the two patients tested, and by the functional outcomes (64% of the reattached eyes had a final visual acuity of 20/40 or better).