Results of surgery for giant retinal tears pre- and post-perfluorocarbon liquids

Purpose. To evaluate the results of surgery for giant retinal tears, pre- and post-usage of perfluoro-n-octane (PFO). Methods. Patients with giant retinal tear not associated with trauma were retrospectively reviewed. Twenty consecutive patients (20 eyes, 27 surgeries) were managed without PFO (1988-1990), while 25 patients (26 eyes, 31 surgeries) were treated with intraoperative PFO (1991-1993). All patients were followed at least 6 months. Results. Both groups had similar percentages of extent of giant retinal tears, proliferative vitreoretinopathy C-3 or greater (30% vs. 31%), and temporary use of silicone oil (26% vs. 29%). The prePFO group (1988-1990) required retinotomy more frequently (41% vs. 16%), and had a higher re-operation rate (35% vs. 19%), excluding the removal of silicone oil. Anatomic success rates were comparable (100% vs. 96%). Vision of 20/40 or better was significantly improved in the PFO group (69%), in contrast to the pre-PFO group (15%). Conclusions. Patients with giant retinal tears managed with PFO fared much better visually, though both groups overall did well anatomically. Small sample size and patient discrepancies between the two groups may explain the visual outcome. It is possible, however, that the improved visual outcome in the PFO group may be related to changes in surgical technique, especially since the use of PFO tended to simplify the surgery which was required to achieve anatomic success.