Clinical Ophthalmology (Feb 2023)
Short-Term Total Tamponade with Perfluorocarbon Liquid and Silicone Oil in Complex Rhegmatogenous Retinal Detachment with Severe Proliferative Vitreoretinopathy
Abstract
Omar Trabelsi,1 Mejda Bouladi,2 Amel Ouertani,1 Ahmed Trabelsi1 1Clinique Ophtalmologique de Tunis, Tunis, Tunisia; 2Department of Surgery, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, TunisiaCorrespondence: Mejda Bouladi, Faculty of Medicine of Tunis, University of Tunis El Manar, 24, rue Amilcar, cité Wifec, 2070, La Marsa, Tunis, Tunisia, Tel +21698561086, Email [email protected]: To evaluate retinal reattachment, visual functional results, and complications rates after total tamponade (TT) with perfluorocarbon liquid (PFCL) and silicone oil (SO) for 2 days followed by PFCL-SO exchange in complex retinal detachment (RD).Methods: Retrospective study including 52 consecutive eyes with complex RD and advanced proliferative vitreoretinopathy, who underwent vitrectomy with TT. Patients underwent first surgery by 25-Gauge vitrectomy and partial PFCL-SO exchange (approximately 60% PFCL 40% SO fill) followed by second surgery with extraction of the PFCL and complete SO fill.Results: After a mean follow-up period of 25.15 ± 6.6 months, the retina remained reattached in 48/52 eyes (92.3%) including 28 eyes (58.3%) without SO and 20 eyes (41.7%) with prolonged SO tamponade. Visual acuity improved in 45 eyes (86.6%) (P< 0.001), remained stable in 4 eyes (7.7%) and decreased in 3 eyes (5.7%). Complications consisted in mild anterior chamber inflammation in 10 eyes, ocular hypertension in 12 eyes, and cataract in 10 eyes.Conclusion: Two-day TT with PFCL and SO may be considered in complex RD with advanced proliferative vitreoretinopathy especially in monocular patients. Further studies with longer follow-up period and retinal electrophysiologic assessment may be needed.Keywords: complex retinal detachment, proliferative vitreoretinopathy, monocular patient, perfluorocarbon liquid, silicone oil, positioning