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PARS PLANA VITRECTOMY WITH MEDIUM-TERM POSTOPERATIVE PERFLUORO-N-OCTANE FOR RECURRENT INFERIOR RETINAL DETACHMENT COMPLICATED BY ADVANCED PROLIFERATIVE VITREORETINOPATHY

Sigler, Eric J. MD; Randolph, John C. MD; Calzada, Jorge I. MD; Charles, Steve MD

doi: 10.1097/IAE.0b013e31826a6978
Original Study

Purpose: To describe a series of patients with recurrent inferior retinal detachment complicated by proliferative vitreoretinopathy (PVR) treated with pars plana vitrectomy and postoperative perfluoro-n-octane (PFO).

Methods: Consecutive patients with recurrent inferior retinal detachment and Grade C PVR were prospectively treated with 25-gauge pars plana vitrectomy and postoperative “medium-term” PFO for 2- to 3-week duration. All patients had subsequent PFO removal in a planned staged procedure.

Results: Forty-four eyes of 44 patients were included. Mean follow-up time was 30.71 ± 12.92 months. Successful reattachment was achieved in 86% of eyes (38/44). Reattachment rates were statistically equivalent between eyes with and without previous scleral buckle. Reasons for redetachment were recurrent inferior PVR (four of six) and new superior break without PVR (two of six). Additional complications observed were cataract progression requiring surgery (42%), persistent intraocular pressure elevation (36%), and transient inflammation (32%). Macula-off status (P = 0.02) and persistent intraocular pressure elevation (P = 0.02) were factors associated with worse visual outcome.

Conclusion: Medium-term PFO was found to be an efficacious technique for operative management of recurrent inferior retinal detachments complicated by Grade C PVR. The method of primary repair (scleral buckle vs. pars plana vitrectomy) did not affect reattachment rates. Transient inflammation and intraocular pressure elevation are potential complications associated with this technique. Persistent intraocular pressure elevation was associated with worse visual outcome.

Two- to three-week duration postoperative PFO followed by subsequent staged PFO removal seems to be an efficacious technique for repairing inferior retinal detachments in eyes with consecutive retinal detachment complicated by Grade C PVR.

Charles Retina Institute, Memphis, Tennessee.

Reprint requests: Eric J. Sigler, MD, Charles Retina Institute, 6401 Poplar Avenue, Suite 190, Memphis, TN 38119; e-mail: ejsigler@gmail.com

The authors have no funding or conflicts of interest to disclose.

Dr. Charles is a consultant for Alcon Laboratories, Fort Worth, TX.

© The Ophthalmic Communications Society, Inc.