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Perfluoro-n-octane, upright head position effective in inferior retinal detachment repair
A staged two-procedure approach involving pars plana vitrectomy, perfluoro-n-octane tamponade and upright head positioning was effective in repairing inferior retinal detachments, according to a study.
The interventional case series analyzed 159 eyes of 157 patients with inferior retinal detachments with and without proliferative vitreoretinopathy.
Patients underwent 25-gauge pars plana vitrectomy followed by perfluoro-n-octane tamponade and upright head positioning. After 2 to 3 weeks, patients underwent a planned secondary pars plana vitrectomy and removal of perfluoro-n-octane.
Successful reattachment was reported in 87.5% of the eyes at the mean postoperative follow-up of 32 ± 4.6 months.
Persistent IOP elevation was found in 54 eyes (34%), making it the most common postoperative complication, followed by granulomatous inflammatory precipitates in 43 eyes (27%) and perfluoro-n-octane in the anterior chamber in 34 eyes (21%). The inflammatory reaction did not appear to have long-term visual or anatomic effects.
After removal of perfluoro-n-octane, some additional complications were observed, including the need for cataract surgery in 22 initially phakic eyes (16%), redetachment in 21 eyes (13%) and the need for filtering surgery in 10 eyes (6%).
Progression to filtering surgery was a significant factor in predicting visual outcome at 1-year follow-up (P = .001), as was macula status (P = .003).
There were several limitations to the study, including the primarily white patient population, the lack of a randomized control group and patients having inferior retinal detachments only.