Skip to main content

Advertisement

SpringerLink
Log in

Surgical outcomes of 27-gauge pars plana vitrectomy with short-term postoperative tamponade of perfluorocarbon liquid for repair of giant retinal tears

  • Original Paper
  • Published:
International Ophthalmology Aims and scope Submit manuscript

Abstract

Purpose

To investigate the use of 27-gauge pars plana vitrectomy (PPV) with short-term tamponade of perfluorocarbon liquid (PFCL) for repair of giant retinal tears (GRT).

Methods

Retrospective case series study. Consecutive patients with GRT were treated with 27-gauge PPV and short-term tamponade of PFCL for 7–10 days. PFCL was completely removed with a secondary surgery.

Results

Twenty-three eyes of 23 patients were included. All the patients achieved primary anatomic success. Preoperative logarithm of the minimum angle of resolution (logMAR) BCVA was 1.59 ± 0.58 (Snellen 20/778). Five (21.7%), nine (39.1%), eleven (47.8%) and fifteen (65.2%) eyes experienced vision improvement at the Month-1, Month-3, Month-6 and final follow-ups, respectively. The final logMAR BCVA was 0.84 ± 0.51 (Snellen 20/138), being statistically better than the preoperative one (P < 0.001). Surgical complications included foreign body response (n = 7), transient elevated intraocular pressure (n = 5), cataract formation/deterioration (n = 11) and posterior capsule opacity (n = 16).

Conclusions

27-Gauge PPV with short-term tamponade of PFCL is safe and effective for the repair of GRT. Side effects of the surgery mainly included foreign body response, transient elevated intraocular pressure, cataract formation/deterioration and posterior capsule opacity.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Ando F, Kondo J (1983) A plastic tack for the treatment of retinal detachment with giant tear. Am J Ophthalmol 95:260–261

    Article  PubMed  CAS  Google Scholar 

  2. Lincoff H (1981) A small bubble technique for manipulating giant retinal tears. Ann Ophthalmol 13:241–243

    PubMed  CAS  Google Scholar 

  3. Kao GW, Peyman GA (1986) Penetrating diathermy for retinal microincarceration in the management of giant retinal tears with inverted flaps. Retina 6:135–145

    Article  PubMed  CAS  Google Scholar 

  4. Machemer R, Allen AW (1976) Retinal tears 180 degrees and greater. Management with vitrectomy and intravitreal gas. Arch Ophthalmol 94:1340–1346

    Article  PubMed  CAS  Google Scholar 

  5. Federman JL, Shakin JL, Lanning RC (1982) The microsurgical management of giant retinal tears with trans-scleral retinal sutures. Ophthalmology 89:832–839

    Article  PubMed  CAS  Google Scholar 

  6. Chang S, Lincoff H, Zimmerman NJ, Fuchs W (1989) Giant retinal tears. Surgical techniques and results using perfluorocarbon liquids. Arch Ophthalmol 107:761–766

    Article  PubMed  CAS  Google Scholar 

  7. Mathis A, Pagot V, Gazagne C, Malecaze F (1992) Giant retinal tears. Surgical techniques and results using perfluorodecalin and silicone oil tamponade. Retina 12:S7–S10

    Article  PubMed  CAS  Google Scholar 

  8. Kertes PJ, Wafapoor H, Peyman GA, Calixto NJ, Thompson H (1997) The management of giant retinal tears using perfluoroperhydrophenanthrene. A multicenter case series. Vitreon Collaborative Study Group. Ophthalmology 104:1159–1165

    Article  PubMed  CAS  Google Scholar 

  9. Elsing SH, Fekrat S, Green WR, Chang S, Wajer SD, Haller JA (2001) Clinicopathologic findings in eyes with retained perfluoro-n-octane liquid. Ophthalmology 108:45–48

    Article  PubMed  CAS  Google Scholar 

  10. Chang S, Sparrow JR, Iwamoto T, Gershbein A, Ross R, Ortiz R (1991) Experimental studies of tolerance to intravitreal perfluoro-n-octane liquid. Retina 11:367–374

    Article  PubMed  CAS  Google Scholar 

  11. Sigler EJ, Randolph JC, Charles S (2014) Foreign body response within postoperative perfluoro-N-octane for retinal detachment repair: clinical features, grading system, and histopathology. Retina 34:237–246

    Article  PubMed  Google Scholar 

  12. Randolph JC, Diaz RI, Sigler EJ, Calzada JI, Charles S (2016) 25-gauge pars plana vitrectomy with medium-term postoperative perfluoro-n-octane for the repair of giant retinal tears. Graefes Arch Clin Exp Ophthalmol 254:253–257

    Article  PubMed  CAS  Google Scholar 

  13. Sigler EJ, Randolph JC, Calzada JI, Charles S (2013) 25-gauge pars plana vitrectomy with medium-term postoperative perfluoro-n-octane tamponade for inferior retinal detachment. Ophthalmic Surg Lasers Imaging Retina 44:34–40

    Article  PubMed  Google Scholar 

  14. Rofail M, Lee LR (2005) Perfluoro-n-octane as a postoperative vitreoretinal tamponade in the management of giant retinal tears. Retina 25:897–901

    Article  PubMed  Google Scholar 

  15. Drury B, Bourke RD (2011) Short-term intraocular tamponade with perfluorocarbon heavy liquid. Br J Ophthalmol 95:694–698

    Article  PubMed  Google Scholar 

  16. Sirimaharaj M, Balachandran C, Chan WC et al (2005) Vitrectomy with short term postoperative tamponade using perfluorocarbon liquid for giant retinal tears. Br J Ophthalmol 89:1176–1179

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  17. Fujii GY, De Juan EJ, Humayun MS et al (2002) A new 25-gauge instrument system for transconjunctival sutureless vitrectomy surgery. Ophthalmology 109:1807–1812

    Article  PubMed  Google Scholar 

  18. Eckardt C (2005) Transconjunctival sutureless 23-gauge vitrectomy. Retina 25:208–211

    Article  PubMed  Google Scholar 

  19. Oshima Y, Wakabayashi T, Sato T, Ohji M, Tano Y (2010) A 27-gauge instrument system for transconjunctival sutureless microincision vitrectomy surgery. Ophthalmology 117:93–102

    Article  PubMed  Google Scholar 

  20. Khan MA, Shahlaee A, Toussaint B et al (2016) Outcomes of 27 gauge microincision vitrectomy surgery for posterior segment disease. Am J Ophthalmol 161:36–43

    Article  PubMed  Google Scholar 

  21. Khan MA, Rahimy E, Gupta OP, Hsu J (2016) Combined 27-Gauge pars plana vitrectomy and scleral fixation of an Akreos AO60 intraocular lens using gore-tex suture. Retina 36:1602–1604

    Article  PubMed  Google Scholar 

  22. Pavlidis M, Korber N, Hohn F (2016) Surgical and functional results of 27-gauge vitrectomy combined with coaxial 1.8 mm microincision cataract surgery: a consecutive case series. Retina 36:2093–2100

    Article  PubMed  Google Scholar 

  23. Gungel H, Altan C, Baylancicek DO, Karagoz Y, Kisbet T (2016) The effects of 23-gauge pars plana vitrectomy on orbital circulation using doppler ultrasonography in diabetic macular edema with epiretinal membrane and taut posterior hyaloid. Curr Eye Res e-pub ahead of print 1 June 2016; doi: 10.3109/02713683.2016.1150492

  24. Rizzo S, Barca F, Caporossi T, Mariotti C (2015) Twenty-seven-gauge vitrectomy for various vitreoretinal diseases. Retina 35:1273–1278

    Article  PubMed  Google Scholar 

  25. Figueroa MS, Ruiz-Moreno JM, Gonzalez DVF et al (2015) Long-term outcomes of 23-gauge pars plana vitrectomy with internal limiting membrane peeling and gas tamponade for myopic traction maculopathy: a prospective study. Retina 35:1836–1843

    Article  PubMed  Google Scholar 

  26. Schonfeld CL (2013) 23-vs 20-gauge pars plana vitrectomy in combination with bimanual microincisional cataract surgery (b-MICS) for the treatment of macular hole and cataract as a one-step procedure. Eye (Lond) 27:952–958

    Article  Google Scholar 

  27. Toygar O, Mi CW, Miller DM, Riemann CD (2016) Outcomes of transconjunctival sutureless 27-gauge vitrectomy with silicone oil infusion. Graefes Arch Clin Exp Ophthalmol 254:2111–2118

    Article  PubMed  CAS  Google Scholar 

  28. Lin J, Su Z, Huang X, Ji X, Yao K (2016) Surgical removal of dense posterior capsule opacification and vitreous floaters in adults by posterior continuous curvilinear capsulorhexis through the pars plana and 23-gauge vitrectomy. Retina 36:2080–2086

    Article  PubMed  Google Scholar 

  29. Mason JR, Yunker JJ, Vail RS et al (2008) Incidence of endophthalmitis following 20-gauge and 25-gauge vitrectomy. Retina 28:1352–1354

    Article  PubMed  Google Scholar 

  30. Dugel PU, Zhou J, Abulon DJ, Buboltz DC (2012) Tissue attraction associated with 20-gauge, 23-gauge, and enhanced 25-gauge dual-pneumatic vitrectomy probes. Retina 32:1761–1766

    Article  PubMed  Google Scholar 

  31. Rizzo S, Genovesi-Ebert F, Belting C (2011) Comparative study between a standard 25-gauge vitrectomy system and a new ultrahigh-speed 25-gauge system with duty cycle control in the treatment of various vitreoretinal diseases. Retina 31:2007–2013

    Article  PubMed  Google Scholar 

  32. Teixeira A, Chong L, Matsuoka N et al (2010) An experimental protocol of the model to quantify traction applied to the retina by vitreous cutters. Invest Ophthalmol Vis Sci 51:4181–4186

    Article  PubMed  Google Scholar 

  33. Teixeira A, Chong LP, Matsuoka N et al (2010) Vitreoretinal traction created by conventional cutters during vitrectomy. Ophthalmology 117:1387–1392

    Article  PubMed  Google Scholar 

  34. Holladay JT (2004) Visual acuity measurements. J Cataract Refract Surg 30:287–290

    Article  PubMed  Google Scholar 

  35. Scott IU, Murray TG, Flynn HJ, Feuer WJ, Schiffman JC (2002) Outcomes and complications associated with giant retinal tear management using perfluoro-n-octane. Ophthalmology 109:1828–1833

    Article  PubMed  Google Scholar 

  36. Dugel PU, Abulon DJ, Dimalanta R (2015) Comparison of attraction capabilities associated with high-speed, dual-pneumatic vitrectomy probes. Retina 35:915–920

    Article  PubMed  Google Scholar 

  37. Eckardt C, Nicolai U, Winter M, Knop E (1991) Experimental intraocular tolerance to liquid perfluorooctane and perfluoropolyether. Retina 11:375–384

    Article  PubMed  CAS  Google Scholar 

  38. Unlu N, Kocaoglan H, Acar MA, Sargin M, Aslan BS, Duman S (2003) The management of giant retinal tears with silicone oil. Eur J Ophthalmol 13:192–195

    Article  PubMed  CAS  Google Scholar 

  39. Pitcher JR, Khan MA, Storey PP et al (2015) Contemporary management of rhegmatogenous retinal detachment due to giant retinal tears: a consecutive case series. Ophthalmic Surg Lasers Imaging Retina 46:566–570

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

Part of this study was supported by a grant from National Natural Science Foundation of China (81570865), and the PhD Start-up Fund of Natural Science Foundation of Guangdong Province, China (2015A030310092).

Author information

Author notes

  1. Zhaotian Zhang and Yantao Wei have contributed equally to this work.

Authors and Affiliations

  1. State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, 54S Xianlie Road, Guangzhou, 510060, China

    Zhaotian Zhang, Yantao Wei, Xintong Jiang & Shaochong Zhang

Authors
  1. Zhaotian Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yantao Wei
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Xintong Jiang
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Shaochong Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Shaochong Zhang.

Ethics declarations

Conflict of interest

All the authors declare there are no competing financial interests in relation to the current study.

Ethical approval

All procedures performed in the studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Zhang, Z., Wei, Y., Jiang, X. et al. Surgical outcomes of 27-gauge pars plana vitrectomy with short-term postoperative tamponade of perfluorocarbon liquid for repair of giant retinal tears. Int Ophthalmol 38, 1505–1513 (2018). https://doi.org/10.1007/s10792-017-0613-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10792-017-0613-4

Keywords

Search

Navigation