PERFLUOROCARBON LIQUIDS AS POSTOPERATIVE SHORT-TERM VITREOUS SUBSTITUTES IN COMPLICATED RETINAL-DETACHMENT

To avoid postoperative ''compartmentalization'' of the vitreous cavity , which can potentially accelerate the recurrence of proliferative vit reoretinopathy (PVR), 32 eyes of 32 selected patients with complicated retinal detachment were managed with lensectomy, vitrectomy, 5-day in ternal tamponade with perfluorocarbon liquids (PFCL) and postoperative supine positioning until PFCL removal. Intraoperatively, 19 eyes had grade C3 or greater PVR; 10 eyes exhibited ocular trauma and 6 display ed giant tears. All but 5 patients (PFCL/fluid exchange) underwent PFC L/silicone oil exchange 5 days after surgery. Anatomic attachment of t he retina was achieved with one operation in 25 (78%) of the 32 eyes w ith a median follow-up of 8 months (mean 8.4 months). Of the 20 eyes t hat underwent silicone oil removal, none redetached. Nineteen eyes (61 %) showed no or only mild reproliferation; a macular pucker developed in 50% of the 20 eyes successfully reattached after PFCL/silicone oil exchange and in none of the 5 eyes successfully reattached after PFCL/ fluid exchange. Intraocular tolerance of PFCL for up to 5 days of inte rnal tamponade appeared to be good as judged by static threshold perim etry in the two patients tested and by our functional outcomes, with 8 8% of the reattached eyes showing a final visual acuity of 5/200 or be tter.