Mathis A, Pagot V, Idder A, Malecaze F
Service d'Ophtalmologie, CHU Rangueil, Toulouse.
J Fr Ophtalmol. 1993;16(11):584-90.
Thirty eyes in 27 patients were operated for complications of proliferative diabetic retinopathy using a perfluorocarbon liquid, highly purified perfluorodecalin; 3 patients were lost to follow-up leaving 27 eyes for evaluation. Fourteen eyes presented traction-rhegmatogenous retinal detachment; 10 eyes underwent vitrectomy for traction retinal detachment and 3 eyes for progressive fibrovascular proliferation: in these 13 eyes, dissection of fibrovascular proliferation was complicated by iatrogenic holes with surrounding retinal detachment. The intraoperative use of perfluorodecalin facilitated flattening of the retina and endophotocoagulation. Perfluorodecalin was removed at the end of the procedure, and intraocular tamponade was provided by silicone oil in 12 cases, and by gas in 15 eyes. Anatomical success was obtained in 21/27 cases with a minimum of 6 months and a maximum of 25 months of follow-up (mean follow-up: 10.9 months). Complications from the intraoperative use of perfluorodecalin were observed in two cases: one patient had residual droplets of perfluorodecalin, which were removed during a reoperation; in another patient, small subretinal droplets of perfluorodecalin were observed postoperatively without apparent toxicity after 22 months of follow-up. Eleven eyes had improved vision, 8 eyes had the same vision, and 8 eyes had decreased vision. The main advantage of intraoperative use of perfluorodecalin was to allow easy flattening of the retina and effective endophotocoagulation under optimal visual conditions.
27例患者的30只眼因增生性糖尿病视网膜病变并发症接受手术,使用全氟碳液体——高纯度全氟萘烷;3例患者失访,剩余27只眼用于评估。14只眼出现牵拉性孔源性视网膜脱离;10只眼因牵拉性视网膜脱离接受玻璃体切除术,3只眼因进行性纤维血管增生接受手术:在这13只眼中,纤维血管增生的剥离因医源性裂孔及周围视网膜脱离而变得复杂。术中使用全氟萘烷有助于视网膜变平及眼内光凝。手术结束时移除全氟萘烷,12例患者用硅油进行眼内填充,15只眼用气体填充。27例中有21例获得解剖学成功,随访时间最短6个月,最长25个月(平均随访:10.9个月)。术中使用全氟萘烷观察到2例并发症:1例患者有全氟萘烷残留液滴,在再次手术时被移除;另1例患者术后观察到视网膜下有小的全氟萘烷液滴,随访22个月后无明显毒性。11只眼视力改善,8只眼视力不变,8只眼视力下降。术中使用全氟萘烷的主要优点是能在最佳视觉条件下使视网膜轻松变平并进行有效的眼内光凝。