title: Evaluation of Vitreous Substitutes in Managing Complicated Vitreo-retinal Surgeries.
abstract: BACKGROUND
  Vitreous substitutes presently in use for intraoperative tamponade are perfluorocarbon liquids (PFCL) and for post operative tamponade are silicon oil (SO), sulphur hexafluoride (SF6) and perfluorocarbon gas (PFC). Several factors are important for a thorough understanding of each of these vitreous substitutes. The absorption or necessity for removal, indications for use (including clinical studies and special surgical methods), additives and complications of use have to be considered.
  
  
  METHODS
  Three port standard pars plana vitrectomy was performed in 60 consecutive cases requiring intra-vitreal intervention. PFCL was used intra-operatively in 30 cases (PFCL group and X group). The eyes were implanted with SO (silicon oil subgroup), PFC (C3F8 sub-group) and SF6 (SF6 sub-group) in twenty cases each. Apart from best corrected visual acuity (BCVA), the retinal status and the longevity of gas when used, changes and reaction in both the anterior and posterior segments were noted.
  
  
  RESULTS
  The difference of postoperative BCVA in the PFCL and non-PFCL groups was statistically significant with p < 0.001. In both the PFCL and non-PFCL groups the difference between preoperative and postoperative BCVA was statistically significant with p < 0.0001. All three vitreous substitutes studied are effective given the case where they had been utilised.
  
  
  CONCLUSIONS
  PFCL is invaluable in the management of complicated retinal detachment (RD). Where a vitreous microsurgery is indicated, the visual outcome is good. SF6 is useful for short-term tamponade. Silicon oil and C3F8 are useful for longer tamponade.
authors.affiliation: Associate Professor, (Department of Ophthalmology), AFMC, Pune-40.
authors.forename: V S
authors.initials: VS
authors.lastname: Gurunadh
authors.affiliation: Professor & Head (Department of Ophthalmology), AFMC, Pune-40.
authors.forename: A
authors.initials: A
authors.lastname: Banarji
authors.affiliation: Associate Professor, (Department of Ophthalmology), AFMC, Pune-40.
authors.forename: S
authors.initials: S
authors.lastname: Patyal
authors.affiliation: Senior Advisor (Ophthalmology), AFCME, Delhi Cantt.
authors.forename: A K
authors.initials: AK
authors.lastname: Upadhyay
authors.affiliation: Senior Advisor (Ophthalmology), Command Hospital (NC), C/o 56 APO.
authors.forename: T S
authors.initials: TS
authors.lastname: Ahluwalia
authors.affiliation: Professor & HOD (Ophthalmology), DY Patil Medical College, Pune.
authors.forename: R P
authors.initials: RP
authors.lastname: Gupta
authors.affiliation: CMO, Sitapur Eye Hospital, Sitapur, UP.
authors.forename: M
authors.initials: M
authors.lastname: Bhaduria
keywords: Perfluorocarbon gas; Perfluorocarbon liquids; Retinal detachment; Silicon oil; Sulphur hexafluoride; Tamponade