THE USE OF PERFLUORODECALIN IN PARS-PLANA VITRECTOMY FOR COMPLICATIONS OF PROLIFERATIVE DIABETIC-RETINOPATHY

Thirty eyes in 27 patients were operated for complications of prolifer ative diabetic retinopathy using a perfluorocarbon liquid, highly puri fied perfluorodecalin ; 3 patients were lost to follow-up leaving 27 e yes for evaluation. Fourteen eyes presented traction-rhegmatogenous re tinal detachment; 10 eyes underwent vitrectomy for traction retinal de tachment and 3 eyes for progressive fibrovascular proliferation : in t hese 13 eyes, dissection of fibrovascular proliferation was complicate d by iatrogenic holes with surrounding retinal detachment. The intraop erative use of perfluorodecalin facilitated flattening of the retina a nd endophotocoagulation. Perfluorodecalin was removed at the end of th e procedure, and intraocular tamponade was provided by silicone oil in 12 cases, and by gas in' 15 eyes. Anatomical success was obtained in 21/27 cases with a minimum of 6 months and a maximum of 25 months of f ollow-up (mean follow-up : 10.9 months). Complications from the intrao perative use of perfluorodecalin were observed in two cases : one pati ent had residual droplets of perfuorodecalin, which were removed durin g reoperation ; in another patient, small subretinal droplets of perfl uorodecalin were observed postoperatively without apparent toxicity af ter 22 months of follow-up. Eleven eyes had improved vision, 8 eyes ha d the same vision, and 8 eyes had decreased vision. The main advantage of intraoperative use of perfluorodecalin was to allow easy flattenin g of the retina and effective endophotocoagulation under optimal visua l conditions.