Reza Ali T
Bangladesh Med Res Counc Bull. 2014 Aug;40(2):63-9. doi: 10.3329/bmrcb.v40i2.25185.
To study outcomes after using perfluoro-n-octane (PFO) as a short-term postoperative vitreous substitute in eyes undergoing primary vitrectomy with or without sclera buckling for complex rhegmatogenous retinal detachments with inferior/multiple breaks or giant retinal tears (GRTs) or retinal detachment with extensive proliferative vitreoretinopathy (PVR).
A prospective study was carried out where in 43 patients (Group 1) PFO was exchanged with silicon oil in the same surgical procedure and in 22 patients (Group 2) PFO was kept for 3 days and then exchanged with silicon oil by a separate surgical procedure. The respective surgeon took the decision whether to exchange PFO on the same day or after 3 days. The patients were followed up for 6 months to analyze the anatomical attachment rates, visual acuity gain, and postoperative complications in both the groups.
There were 33 male and 10 female patients in group 1 and 18 male and 4 female patients in group 2. Mean age distribution in group 1 was 38.88 years (SD ± 21.45) and in group 2 was 38.09 years (SD ± 16.36). Mean preoperative best corrected visual acuity in group 1 was 2.02 ± 0.58 and in group 2 was 2.01 ± 0.53 logarithm of the minimum angle of resolution (LogMAR). The LogMAR Visual acuity in group 1 improved to 1.76 ± 0.43 after 1 month (P = 0.01, paired t test) and to 1.62 ± 0.62 after 6 months (P = 0.01, paired T test). This visual acuity in group 2 improved to 1.85 ± 0.42 after 1 month (P = 0.24, paired T test) and 1.90 ± 0.72 after 6 months (P = 0.49, paired T test). There was no difference regarding visual improvement in between two groups after 1 month and 6 months of follow-up (P = 0.125, independent sample T test). The retina was detached in 6 patients (14%) in group 1 and in 7 patients (31%) in group 2 after 6 months of follow-up. There was no statistically significant difference in between two groups regarding final attachment of retina (P = 0.109, Fisher exact test). There was also no significant complication. like increased posterior capsular opacification or glaucoma found after retaining PFO for 3 days. Conclusion: Perfluoro-n-octane is efficacious and safe as a short-term vitreous substitute in primary rhegmatogenous retinal detachment repair cases with inferior/multiple breaks or GRTs or with extensive PVR. But keeping perfluoro-n-octane for 3 days does not significantly reduce the risk of re-detachment with complex rhegmatogenous retinal detachment cases.
研究在接受一期玻璃体切除术治疗伴有下方/多发裂孔、巨大视网膜裂孔（GRT）或广泛增生性玻璃体视网膜病变（PVR）的复杂性孔源性视网膜脱离且行或不行巩膜扣带术的眼中，使用全氟正辛烷（PFO）作为短期术后玻璃体替代物的效果。
进行一项前瞻性研究，43例患者（第1组）在同一手术过程中将PFO与硅油交换，22例患者（第2组）将PFO保留3天，然后通过单独的手术过程与硅油交换。由各自的外科医生决定是在同一天还是3天后交换PFO。对患者进行6个月的随访，分析两组的视网膜解剖复位率、视力提高情况和术后并发症。
第1组有33例男性和10例女性患者，第2组有18例男性和4例女性患者。第1组的平均年龄分布为38.88岁（标准差±21.45），第2组为38.０9岁（标准差±16.36）。第1组术前平均最佳矫正视力为2.02±0.58，第2组为2.01±0.53最小分辨角对数（LogMAR）。第1组的LogMAR视力在1个月后提高到1.76±0.43（P = 0.01，配对t检验），6个月后提高到1.62±0.62（P = 0.01，配对t检验）。第2组的视力在1个月后提高到1.85±0.42（P = 0.24，配对t检验），6个月后提高到1.90±0.72（P = 0.49，配对t检验）。随访1个月和6个月后，两组之间的视力改善无差异（P = 0.125，独立样本t检验）。随访6个月后，第1组有6例患者（14%）视网膜脱离，第2组有7例患者（31%）视网膜脱离。两组之间视网膜最终复位情况无统计学显著差异（P = 0.109，Fisher精确检验）。也没有发现明显的并发症，如保留PFO 3天后后囊膜混浊增加或青光眼。结论：在伴有下方/多发裂孔、GRT或广泛PVR的原发性孔源性视网膜脱离修复病例中，全氟正辛烷作为短期玻璃体替代物是有效且安全的。但在复杂性孔源性视网膜脱离病例中，将全氟正辛烷保留3天并不能显著降低再次脱离的风险。
