The adjunctive use of perfluoroperhydrophenanthrene (Vitreon) in diabetic vitrectomy

Objective: To evaluate the utility and efficacy of perfluoroperhydrophenant hrene in the management of retinal detachments secondary to severe prolifer ative diabetic retinopathy. Patients and Methods: Forty consecutive patient s with proliferative diabetic retinopathy and retinal detachments were ente red into the study at nine participating clinical centers. Perfluoroperhydr ophenanthrene (Vitreon) was used as an adjunct to pars plana vitrectomy and membranectomy. Results: Preoperative diagnoses included combined traction and rhegmatogenous retinal detachments in 23 eyes (57.5%), traction retinal detachments in 13 eyes (32.5%), and recurrent rhegmatogenous retinal detac hments in 4 eyes (10%). Vitreous hemorrhage was present in 17 eyes (42.5%). Preoperative visual acuity ranged from light perception or hand motion in 28 eyes (70%) to 5/200 or greater in 12 eyes (30%). Vitreon was primarily u sed to flatten the retina following relaxing retinotomy in 12 eyes (30%), t o displace subretinal fluid in a posterior-to-anterior direction without pe rforming a drainage retinotomy in 15 eyes (37.5%), and to manage intraopera tive complications such as iatrogenic tears in 8 (20%) and retinal dialysis in 5 eyes (12.5%). The retina flattened intraoperatively in all cases, fac ilitating administration of laser photocoagulation. Patients were followed for a minimum of six months (mean 13.2 months). At last follow up, the macu la remained attached in 37 eyes (92.5%), including 31 (77.5%) in which the retina was totally attached. The retina remained detached in 3 eyes (7.5%). Visual acuity improved postoperatively in 20 patients (50%), was unchanged in 13 patients (32.5%), and worsened in 7 patients (17.5%). Conclusions: P erfluoroperhydrophenanthrene is a useful and effective intraoperative tool for the management of complex retinal detachments secondary to severe proli ferative diabetic retinopathy.