Perfluoropropane gas, modified panretinal photocoagulation, and vitrectomy in the management of severe proliferative vitreoretinopathy
Y. L. Fisher, J. L. Shakin, J. S. Slakter, J. A. Sorenson and D. M. Shafer
Manhattan Eye, Ear and Throat Hospital, New York.
Seventy-six consecutive patients with total rhegmatogenous retinal
detachments and severe proliferative vitreoretinopathy underwent combined
pars plana vitrectomy, lensectomy, panretinal photocoagulation,
perfluoropropane gas (C3F8)/fluid exchange, and scleral buckling. Sixty-two
(82%) of the patients had successful, sustained (greater than 12 months)
posterior retinal reattachments at last examination. Of these 62 patients,
40 (65%) had complete retinal attachment, with no evidence of regrowth of
periretinal membranes or redetachments following the initial procedure. In
the remaining 22 cases with successful reattachment of the retina posterior
to the equator, partial peripheral retinal detachments were observed. In 16
of the 22 cases, the detachments occurred entirely anterior to the boundary
of the previously placed photocoagulation lesions. The posterior retina
remained uninvolved, and no further treatment was needed. Reoperation was
required in the other six patients to achieve sustained posterior retinal
reattachment. Postoperative visual acuity ranged from 20/40 to bare light
perception, with 69% of the anatomically successful cases obtaining
functional visual acuity (greater than 20/400). Failures were related to
reproliferation of fibrous membranes.
