The Management of Giant Retinal Tears Using Perfluoroperhydrophenanthrene

Kertes, Peter J.; Wafapoor, H.; Calixto, Nassim; Thompson, Hilary W.; Peyman, Gholam A.; Williams, George A.; Werner, Jane C.; Olk, R. Joseph; Flynn, Harry W.; Mani, Hamid; Paylor, Ralph R.; Campochiaro, Peter A.; Bennett, Thomas O.; Schulman, Joel A.; Blinder, Kevin J.; Wendel, Robert; Medlock, Rickey; Glaser, Bert M.; Randall, J. G.; Chen, Ching J.; Federman, Jay L.; Tasman, William; Mehta, Nalin J.; Zakov, Nicholas; Sanborn, George E.; Brourman, Neil D.; Elman, Michael J.

doi:10.1016/s0161-6420(97)30168-7

Cited by 96 publications

(50 citation statements)

References 22 publications

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“…6 The results of surgery for retinal detachments and GRTs have vastly improved over the years ( Figure 6), 2,[7][8][9][10][11][12] particularly after the introduction of perfluorocarbon liquids by Chang, enabling controlled, atraumatic unfolding of the retinal flap of the GRT. 11 Most centres now report success rates of at least 70%. In our centre, we were able to achieve surgical success in 84.8% after a mean of 1.19 surgeries, of which 71.7% were re-attached after only one operation.…”

Section: Discussionmentioning

confidence: 99%

Giant retinal tear management: an Asian experience

Lee

Ong

Wong

et al. 2008

Eye

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Purpose To report the management of giant retinal tears (GRT). Methods Retrospective review of all patients who underwent surgery for GRT with at least 6 months follow-up. Results A total of 124 patients with 128 eyes were managed for GRT between 1991 and 2005. Of them, 99 eyes of 96 patients with at least 6 months follow-up were reviewed (mean follow-up 63.38 months). There were 113 men and the mean age was 39.6 years (8-72 years). Myopia was present in 81 eyes (63.3%) with mean myopia À7.56 dioptres sphere, DS (À1.00 to À27.00 DS). All eyes underwent pars plana vitrectomy. Scleral buckling was done in 90 eyes (70.3%) and lens removal in 49 of 95 phakic eyes (51.2%). Total 84 eyes (84.8%) were re-attached at 6 months after vitrectomy. This was achieved with one surgery in 71 eyes (71.7%). The mean number of surgeries for reattachment was 1.19 surgeries. At 6 months, 41 eyes (41.4%) regained 20/40 or better vision. A total of 47 vitreoretinal pathologies were seen in the fellow eyes of the 124 patients, including 4 with GRTs. Conclusion Surgical success for GRT can be achieved with good visual outcome in 84.8% after a mean of 1.19 surgeries. The fellow eyes are however at risk of pathologies and should be followed-up in the long term.

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Section: Discussionmentioning

confidence: 99%

Giant retinal tear management: an Asian experience

Lee

Ong

Wong

et al. 2008

Eye

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“…42 Other authors have found a good tolerance in a subset of patients with a longer intraocular PFCL tamponade. 7 However, the anatomical and functional results 5,7,43 could not demonstrate a meaningful advantage over standard surgical techniques. In addition, PFCL has to be replaced by a conventional long-term tamponade in the majority of patients to maintain retinal reattachment.…”

Section: Fluorinated Silicone and Perfluorocarbon Liquidsmentioning

confidence: 98%

“…[1][2][3] The first heavy tamponades, fluorosilicone and perfluorocarbons, were introduced into clinical practise in the early 1990s. [4][5][6][7][8] It soon emerged, however, that these substances could only be used intraoperatively and as a shortterm tamponade, too short a time that would have been needed to treat complicated cases of proliferative vitreoretinopathy (PVR). 9,10 The next substance in use as a long-term heavy tamponade, one which achieved certification in Europe for several clinical studies in the early 2000s was perfluorohexyloctane (F6H8).…”

Section: Introductionmentioning

confidence: 99%

Heavy tamponade 1: a review of indications, use, and complications

Heimann

Stappler

Wong

2008

Eye

117

125

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Background Heavier than water intraocular tamponades have several theoretical advantages over conventional tamponades, especially in the treatment of complicated retinal detachments and proliferative viteroretinopathy of the lower fundus periphery. However, initial clinical series of various heavy tamponades have reported significant complication rates. Therefore, heavy tamponades have not found widespread acceptance. Three recently developed heavy silicone oil tamponades, Oxane HD, Densiron 68, and HWS 46-3000, are much better tolerated and presently seem to enter routine clinical practice. Materials and methods Literature review of 21 publications on the clinical application of 9 different heavy tamponades (fluorosilicone, C10F18, F6H8, OL62HV, Oxane HD, O62, F6H8-silicone oil mixture, Densiron 68, and HWS 46-3000). Results The first generation (fluorinated silicone and perfluorocarbon liquids) and second generation (partially fluorinated alkanes) of heavy tamponades were associated with relatively high complication rates, for example, tamponade emulsification, intraocular inflammation, and rise in intraocular pressure. The complication spectrum of the new generation of heavy silicone oils (Oxane HD, Densiron 68, and HWS 46-3000) seems to be comparable to conventional silicone oil tamponades while providing better support for the inferior retina and the posterior pole. Conclusion The recently developed heavy silicone oil tamponades are safe and effective tools for the use of complicated retinal detachments of the inferior fundus.

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“…For example in giant retinal tears (which are often excluded from series of primary retinal detachment), the incidence varies from 16-41% in recent series. [9][10][11][12][13] In penetrating ocular trauma the underlying pathophysiology of PVR is modified by additional factors such as the presence of uveitis and a greater degree of blood-ocular barrier breakdown and vitreous haemorrhage. Exogenous cell types may also be present, for example episcleral fibroblasts introduced at the time of the penetrating injury.…”

Section: Incidencementioning

confidence: 99%