[Primary vitrectomy for rhegmatogenous retinal detachment without use of heavy liquids]

The purpose of this study was to analyse the outcome of vitrectomy for rhegmatogenous retinal detachment without intraoperative use of heavy perfluorocarbon liquids (PFCL).

All patients who had undergone vitrectomy with a PFCL-free approach during 4/2001-3/2008 by one single surgeon were recruited retrospectively from the electronic database and their data analysed.

A total of 79 patients (42 pseudophakic, 37 phakic) with unilateral surgery were included in the study. The median follow-up was 20.5 months (minimum 3, maximum 133). Median preoperative best-corrected visual acuity was 0.5 logMAR (minimum 0, maximum 2.5) as compared to a postoperative median of 0.45 logMAR (minimum - 0.2, maximum 1.3). The primary anatomic success rate (portion of patients not requiring further retinal surgery, including macular pucker or macular hole surgery) was 70 % for the phakic group, 71 % for the pseudophakic group, and 71 % for all cases. The redetachment rate was 19 % for all cases. The final reattachment rate was 100 %. Complications requiring a repeat surgical intervention occurred in 23 cases, including 7 patients (9 %) with proliferative vitreoretinopathy, and 4 patients (5 %) with macular pucker and macular hole each.

Even though this surgical procedure avoids possible disadvantages of retained intraocular PFCL and may be more cost-effective, the potential benefits do not outweigh the reduced primary anatomic success rate. The authors therefore recommend this approach in selected cases only.