[Personal experience with expanding gases in pars plana vitrectomy]

At the Second Ophthalmological Clinic in Prague the authors operated between January 1991 and November 1993 50 patients, 33 men and 17 women. The mean age of the patients was 43.6 years, the minimum observation period 5 months. In all patients pars plana vitrectomy was performed (PPV) and at the end of the operation or subsequently into the vitreous space the expansive gas SF6 (hexafluorosulphide) or C3F8 (perfluoropropane) was insufflated. In all instances the authors indicated the expansive gas for treatment or prevention of retinal detachment and with regard to this they divided the patients into two groups: 1. From the total number of 50 patients the authors operated in the first group 31 patients with complicated retinal detachment (RD). In 17 patient RD with large postequatorial tears and traces of blood in the vitreous space were involved. In 7 patients the cause of RD was a severe eye injury. In five patients the authors found a macular opening, in one patient a large postequatorial tear in the temporal half and in one patient a circumscribed tractional RD associated with diabetic proliferative retinopathy was involved. 2. In the second group of 19 patients the gas was used as prevention of RD. In 5 patients after transvitreal extraction of a foreign intraocular body with suspected or obvious retinal defect. In two patients after extraction of a posterior lenticular luxation following severe contusion of the eye. In the remaining 12 patients the expansive gas was used after removal of silicone oil (SO) and the gas was used at the same time to prevent hypotonia of the eye. Anatomical results of surgery. 1. In the group of 31 patients with complicated RD after PPV and gas insufflation the retina adhered anatomically in 23 patients (74%). In the group with PVR C1-C3 in 13 patients after gas insufflation the retina became attached in 10 patients (76.9%). In one of these patients after three months accentuated cerclage was performed because of a new fissure. 2. In the group of 19 patients where gas was used for preventive reasons the retina became detached only after removal of SO in 5 of 12 patients (42%). Functional results of operation. To assess final vision the authors evaluated in the first group a total of 39 patients only after gas insufflation and in the second group another 11 patients after reoperation with implantation of SO.(ABSTRACT TRUNCATED AT 400 WORDS)