Perfluoro-n-octane (PFO) usage during vitrectomy for severe diabetic retinopathy with retinal detachment

Purpose. Perfluorocarbon liquids have been successfully used in the surgical management of complicated retinal detachments, giant retinal tears and proliferative vitreoretinopathy. We report our experience with PFO in the surgical management of tractional or combined fractional and rhegmatogenous diabetic retinal detachments. Methods. The records of 16 consecutive eyes with severe diabetic retinopathy and retinal detachment managed by pars plana vitrectomy with PFO usage were reviewed. Pre-operative, intraoperative, and post-operative findings and course were recorded. Risk factors for poor outcome were analyzed using Fisher's exact test. Results. The median pre-operative acuity was 1/200 (range, 20/25 to light perception). Average follow-up was eight months. At the last follow-up visit, the retina was attached in 14 eyes (88%). Median final acuity was 5/200 (range, 20/20 to no light perception). Among the 11 eyes with stable or improved acuity, median final acuity was 20/400; among the five eyes which worsened it was hand motions. Eyes with poor outcome had a significantly greater frequency of scleral buckling (p=0.036), anterior loop dissection (p=0.032), and silicone oil tamponade (p=0.036). Final acuity in the operative eye was better than or equal to that in the fellow eye in seven of the 16 eyes. Conclusions. In our experience, PFO is helpful in the anatomic reattachment of complicated tractional or combined diabetic retinal detachments. In this series, vision was stabilized or improved in a majority of eyes.