Outcome of urgery for retinal detachment aociated with proliferative vitreoretinopathy uing perfluoro-n-octane: a multicenter tudy

Purpoe To report viual acuity and anatomical outcome, a well a complication, of management of complex retinal detachment with proliferative vitreoretinopathy uing par plana vitrectomy and intraoperative perfluoro-n-octane (PFO), and to invetigate clinical feature aociated with anatomical and viual acuity outcome. Deign Propective, noncomparative, interventional multicenter tudy. Method The tudy included 555 patient (555 eye) 15 month of age or older who underwent par plana vitrectomy for complex retinal detachment aociated with proliferative vitreoretinopathy with intraoperative PFO at 24 tudy ite between April 1994 and February 1996. Main outcome meaure included viual acuity and rate of retinal reattachment, reoperation, retained PFO, corneal edema, elevated intraocular preure ([IOP] > 25 mm Hg), hypotony (IOP < 5 mm Hg), and cataract. All outcome meaure were aeed at 1 day, 1 week, 1 month, 3 month, and 6 month potoperatively and at the lat examination. Reult The tudy included 555 eye of 555 patient followed up at a median of 5.6 month. Viual acuity of 20/200 or better wa recorded in 51 (10%) patient preoperatively and 85 (24%) at 6 month potoperatively. Among the 465 eye with both preoperative and final viual acuitie available, potoperative viual acuity improved in 274 (60%) eye, remained table in 106 (23%), and worened in 85 (18%) eye. ix-month follow-up data were obtained for 356 (65%) eye; the retina wa attached in 279 (78%) eye and retained PFO wa noted in 20 (6%). Throughout follow-up, 238 of 555 (43%) eye underwent reoperation for recurrent retinal detachment. At 6 month, corneal edema, elevated IOP, and hypotony were noted in 26 of 356 (7%), 6 of 356 (2%), and 48 of 356 (15%) eye, repectively. Of the 114 phakic eye without ignificant cataract preoperatively, 105 (92%) developed a ignificant cataract or underwent cataract urgery during tudy follow-up. Operative factor ignificantly (P < .05) aociated with recurrent retinal detachment include female gender, creation of a relaxing retinotomy, and the ue of ulfur hexafluoride (F6) ga tamponade, air tamponade, or no tamponade (compared with perfluoropropane [C3F8] or ilicone oil tamponade). Factor ignificantly aociated with final viion of 20/200 or better include firt operation anatomic ucce, prior cleral buckling procedure, no diabete mellitu, no prior vitrectomy, no ilicone oil retinal tamponade, and no relaxing retinotomy. Cae that require relaxing retinotomy generally repreent more evere cae of complex retinal detachment and, therefore, relaxing retinotomy i likely aociated with a poorer viual outcome owing to the nature of the cae elected for thi procedure. Concluion In the management of complex retinal detachment aociated with proliferative vitreoretinopathy, par plana vitrectomy and ue of intraoperative PFO wa aociated with retinal reattachment and preerved viual acuity in mot eye.