Perfluorocarbon liquid vitreous delamination and wide-angle viewing system in the management of complicated diabetic retinal detachment.
OBJECTIVE
The authors used perfluorocarbon liquid (PFCL) and a wide-angle viewing system (WAVS) to evaluate their efficacy on tractional and combined tractional/rhegmatogenous retinal detachment (RD) secondary to proliferative diabetic retinopathy (PDR).


METHODS
In a prospective, noncomparative, interventional study, 76 consecutive cases of severe PDR with tractional and combined tractional/rhegmatogenous RD were submitted to vitrectomy en bloc excision technique using a WAVS and delamination with PFCL between July 1999 and December 2003. None of the patients had had previous retinal photocoagulation treatment. Preoperative characteristics, intraoperative findings, and procedures as well as postoperative results were recorded. Main outcome measures included visual acuity (VA) and rates of retinal reattachment and complications.


RESULTS
After 1 to 4 years of follow-up (mean 34.3 months), the number of patients changed from 3 (3.95%) to 11 patients (14.47%) in the > or =20/40 VA range, from 12 (15.79%) to 7 (9.21%) in the 20/50 to 20/200 group, and from 61 (80.26%) to 58 (76.31%) in the < or =20/400 group, preoperatively and postoperatively, respectively. The mean final VA improved from 1.2 log-MAR before surgery to 0.89 after vitrectomy (p=0.001). This modified technique resulted in less bleeding during surgery, a better identification of intraocular structures, faster retinal reattachment, subretinal fluid reabsorption, and easier dissection of fibrovascular membranes, among other benefits.


CONCLUSIONS
PFCL and WAVS appear to reduce intraoperative complication rates in the management of complicated cases of tractional and combined tractional/rhegmatogenous RD secondary to PDR. Retinal reattachment and functional vision rates improved after this technique.
Yadarola
Maria B
MB
Departamento de Oftalmología, Centro de Ojos Romagosa-Fundación VER, Córdoba, Argentina.
Gramajo
Ana L
AL
Arrambide
Maria P
MP
Colombres
Gustavo A
GA
Juarez
Claudio P
CP
Luna
José D
JD
D000328:Adult; D000368:Aged; D003930:Diabetic Retinopathy / Q000150:complications*; D005260:Female; D005466:Fluorocarbons / Q000627:therapeutic use*; D006801:Humans; D007431:Intraoperative Complications / Q000517:prevention & control; D017075:Laser Coagulation; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012163:Retinal Detachment / Q000209:etiology / Q000601:surgery*; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy / Q000295:instrumentation* / Q000379:methods; D014822:Vitreous Body / Q000601:surgery*
D005466:Fluorocarbons