MANAGEMENT OF GIANT RETINAL TEARS USING TRANSSCLERAL DIODE LASER RETINOPEXY AND SHORT-TERM POSTOPERATIVE TAMPONADE WITH PERFLUORO-N-OCTANE. Issue 3 (March 2020)

• Record Type: Journal Article
• Authors: Bhardwaj, Gaurav; Connell, Paul P.; Campbell, William G.
• Is Part Of: Retina. Volume 40:Issue 3(2020)
• Publication Date: 2020-03
• Subjects: giant retinal tear -- perfluoro-n-octane -- perfluorocarbon liquid -- retinal detachment -- transscleral diode laser retinopexy -- vitrectomy; Retina -- Diseases -- Periodicals; Retinal Diseases; Vitreous Body; 617.735
• DOI: 10.1097/IAE.0000000000002424
• Languages: English
• ISSNs: 0275-004X

Abstract

Abstract : Purpose: To determine the results of pars plana vitrectomy for giant retinal tear detachments using transscleral diode laser retinopexy and short-term postoperative tamponade with perfluoro-n-octane (PFnO). Methods: Twenty consecutive patients with fresh giant retinal tears were enrolled in a single-arm prospective study. One case was withdrawn for technical reasons. The remainder all underwent pars plana vitrectomy, PFnO injection, transscleral diode laser retinopexy to the edge of the giant retinal tear, and short-term postoperative heavy liquid tamponade. None of the cases had scleral buckling or lensectomy. Results: Nineteen cases (18 male and 1 female) with a mean age of 41 years (range 10–69 years) were followed up for a period of 6 months. Postoperative tamponade with PFnO was maintained for a mean of 7.6 days (range 4–21 days), after which it was exchanged for sulfur hexafluoride (SF6 ), perfluoropropane (C3 F8 ) gas, or balanced salt solution. Final reattachment rate was 100%, with 3 (15.7%) patients requiring additional surgery. Best-corrected visual acuity at final follow-up was 20/40 or better in 11 eyes (58%), between 20/60 and 20/200 in 7 (37%), and 20/400 in 1 (5%). Conclusion: In this series of acute giant retinal tears, transscleral diode laser retinopexy together with the use of PFnO for short-term postoperative tamponade achieved excellent anatomical and visual results. Abstract : Vitrectomy and transscleral diode laser retinopexy followed by short-term postoperative tamponade with perfluoro-n-octane is highly effective in retinal detachment secondary to giant retinal tear. In a prospective study, a primary and final anatomical success rate of 84% and 100%, respectively, was achieved, with 79% of patients demonstrating improved best-corrected visual acuity.