title: Postoperative perfluoro-N-octane tamponade for primary retinal detachment repair.
abstract: OBJECTIVE
  To study outcomes after using perfluoro-n-octane (PFO) as a short-term postoperative vitreous substitute in eyes undergoing primary vitrectomy with or without scleral buckling for rhegmatogenous retinal detachments with inferior/multiple breaks or giant retinal tears (GRTs).
  
  
  METHODS
  Charts of 39 eyes at 3-24 months after primary PFO retention and secondary replacement were retrospectively analyzed for anatomical attachment rates, visual acuity gain, and postoperative complications.
  
  
  RESULTS
  Intraoperatively, 33 of 39 eyes showed ≥ 4 retinal breaks, with 31 of 39 eyes having at least 1 inferior break, 10 of 39 eyes having GRT, and 12 of 39 eyes showing preoperative proliferative vitreoretinopathy. All eyes showed complete anatomical retinal attachment after primary vitrectomy for at least 7-17 days when PFO was retained without any specific posturing. With sulfur hexafluoride (SF6) gas PFO exchange, 3 cases redetached. With perfluoropropane (C3F8) gas or silicone oil PFO exchange, no cases redetached, resulting in a final anatomical success rate of 92.4%. Visual acuity improved from 2.07 ± 0.86 to 0.76 ± 0.79 logarithm of the minimum angle of resolution (P < 0.0004) among macula-off and from 0.11 ± 0.08 to 0.12 ± 0.09 logarithm of the minimum angle of resolution (P > 0.05) among macula-on rhegmatogenous retinal detachment eyes. Perfluoro-n-octane retention ≥ 10 days significantly increased posterior capsular opacification (28 of 39 eyes) and cataract extraction rates (21 of 25 eyes) without affecting the final retinal attachment success rate.
  
  
  CONCLUSIONS
  Perfluoro-n-octane is efficacious and safe as a short-term vitreous substitute in primary rhegmatogenous retinal detachment repair cases with inferior/multiple breaks or GRTs. Perfluoro-n-octane removal within 10 days reduces its side effect profile considerably. The highest anatomical retinal reattachment rates were observed when C3F8 or silicone oil was exchanged for PFO.
authors.affiliation: Sydney Eye Hospital, Sydney, Australia. ryanbradfordrush21@hotmail.com
authors.forename: Ryan
authors.initials: R
authors.lastname: Rush
authors.forename: Saumil
authors.initials: S
authors.lastname: Sheth
authors.forename: Sam
authors.initials: S
authors.lastname: Surka
authors.forename: Ivan
authors.initials: I
authors.lastname: Ho
authors.forename: John
authors.initials: J
authors.lastname: Gregory-Roberts
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005466:Fluorocarbons / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D012163:Retinal Detachment / Q000628:therapy*; D014792:Visual Acuity; D014821:Vitrectomy / Q000379:methods*
chemical_list: D005466:Fluorocarbons; C073608:perfluorooctane