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Advantages:

Heavy perfluorocarbon liquids (PFCL) were first used regularly by Chang since 1987 and represents in complex rhegmatogenous retinal detachment (RRD) surgery a unique tool. Because of it´s tamponade pressure, 12 to 14 times more than silicon oil (SO), this liquid is able to express subretinal fluid posteriorly in many cases, without a posterior retinotomy, and also flatten the retina or reattach it in a fairly easy way. Also, it allows a good visibility for many intraoperative procedures such as endolaser. Nevertheless, many complications of its utilization during retinal detachment surgery have been described, including subretinal retention. Because of that, probably, PFCL shouldn’t be used has a routine tool.

The objective of this study is to analyse the anatomical and functional outcomes and safety of vitrectomy for RRD without using PFCL.

Methods:

Retrospective analysis of a case series of 217 patients with RRD who had undergone vitrectomy 23-gauge without using PFCL. Those surgeries were performed by 3 surgeons, between 2-1-2009 and 30-12-2013, at the Hospital de Egas Moniz, Lisbon- Portugal.

Effectiveness / Safety:

The group of the studied patients presented a mean age of 64 years ± 12.04 and a mean follow-up of 9.69 months ± 7.88. There was a statistically significant improvement in best-corrected visual acuity from 0.21 ± 0.27 to 0.44 ± 0.33 (p<0.001 – Wilcoxon) and an intra-ocular pressure increase from 13.19 mmHg ± 4.49 to 15.35 mmHg ± 5.97 (p=.023 Wilcoxon). Twenty percent of the cases (45 eyes) needed a second operation, and 5% (11 eyes) a third one. In the present study, the anatomic and funcional results are comparable with those described in the literature using PFCL. According with those results the authors consider that, in the context of RRD surgery, PFCL should be reserved only for the most complicated cases.