SURGICAL-MANAGEMENT OF TRAUMATIC RETINAL-DETACHMENT WITH PERFLUOROCARBON LIQUID

Background: To evaluate the effect of perfluoroperhydrophenanthrene on the outcome of traumatic retinal detachment with proliferative vitreo retinopathy, a retrospective study of 111 patients was performed at 35 tertiary care centers, both private practice and institutional. We be lieved that perfluoroperhydrophenanthrene would assist in manipulating the retina during surgery, removing intraocular foreign bodies, drain ing suprachoroidal hemorrhage, and reattaching the retina because of t he perfluorocarbon's high specific gravity. Methods: Of the 700 patien ts in the Vitreon study group, 111 with a history of trauma (109 had r etinal detachment, 50 had proliferative vitreoretinopathy) were chosen for this study. Perfluoroperhydrophenanthrene was used intraoperative ly to manipulate the retina hydrokinetically, remove intraocular forei gn bodies, drain suprachoroidal hemorrhage, and to reattach the retina in the case of giant tears. Results: Logistic multiple regression ana lysis was used to identify factors as being predictive of poor visual outcome. Factors predictive of poor visual outcome were: type of traum a (p = 0.0065) (ruptured globe); presence of giant retinal tear (p = 0 .0253); and low preoperative visual acuity (p = 0.044). At the last fo llow-up examination, the reattachment rate was 75.6% (i.e., 84 eyes). Of those 84 eyes, 55 (49.5%) had achieved a visual acuity of greater t han or equal to 5/200 and 34 (30.6%) had a visual acuity of greater th an or equal to 20/200. In cases complicated by proliferative vitreoret inopathy, the final reattachment rate was 66%, with 40% of the eyes st udied obtaining a visual acuity of greater than or equal to 5/200. Con clusions: Perfluoroperhydrophenanthrene has been used intraoperatively in the management of traumatic retinal detachments without any appare nt ill effects.