[Use of perfluorodecalin during vitrectomy in diabetics]

Thirty eyes in 27 patients were operated for complications of proliferative diabetic retinopathy using a perfluorocarbon liquid, highly purified perfluorodecalin; 3 patients were lost to follow-up leaving 27 eyes for evaluation. Fourteen eyes presented traction-rhegmatogenous retinal detachment; 10 eyes underwent vitrectomy for traction retinal detachment and 3 eyes for progressive fibrovascular proliferation: in these 13 eyes, dissection of fibrovascular proliferation was complicated by iatrogenic holes with surrounding retinal detachment. The intraoperative use of perfluorodecalin facilitated flattening of the retina and endophotocoagulation. Perfluorodecalin was removed at the end of the procedure, and intraocular tamponade was provided by silicone oil in 12 cases, and by gas in 15 eyes. Anatomical success was obtained in 21/27 cases with a minimum of 6 months and a maximum of 25 months of follow-up (mean follow-up: 10.9 months). Complications from the intraoperative use of perfluorodecalin were observed in two cases: one patient had residual droplets of perfluorodecalin, which were removed during a reoperation; in another patient, small subretinal droplets of perfluorodecalin were observed postoperatively without apparent toxicity after 22 months of follow-up. Eleven eyes had improved vision, 8 eyes had the same vision, and 8 eyes had decreased vision. The main advantage of intraoperative use of perfluorodecalin was to allow easy flattening of the retina and effective endophotocoagulation under optimal visual conditions.