Session Title: Vitreoretinal Surgery IV
Session Date/Time: Sunday 20/09/2015 | 09:00-10:30
Paper Time: 09:00
First Author: : H.Yetik TURKEY
Co Author(s): : C. Dogan S. Sirop
PURPOSE:It is generally accepted as inoperable if a retinal tear is added to the traction retinal detachment of ROP cases during either follow up or intraoperative period. In this study our experience of a surgical technique including a midterm liquid per-fluorocarbon (decaline) tamponade for those otherwise inoperable ROP cases is shared.
Institutional, prospective, non-masking, non-randomised, interventional case series study performed in Surp Pırgic Armenian Hospital
A total of 10 ROP cases with combined rhegmatogenous and traction retinal detachment were included. All the cases were referred from another centre for vitrectomy operation. 4 cases had a retinal tear at the margin of laser spots in the border between Zone-I and -II preoperatively and remaining 6 cases had iatrogenic retinal tears all at the posterior margin of laser spots developed during the lens-sparing vitrectomy procedure performed for stage 4b ROP. For all the cases without attempting to detach the posterior hyaloid all traction membranes were excised throughout the retinal surface and the vitreous cavity was completely filled by perfluorodecaline and laser photocoagulation of the tears was performed. For 4 cases lens-sparing vitrectomy and retinal reattachment could be completed and for other 3 cases retinal reattachment was achieved after removing the lens (lensectomy) and for remaining 3 cases retinal reattachment couldn't be achieved even after large retinectomy and lensectomy but the surgery was completed by filling the eye with perfluorodecaline. Patients were followed up for 10,77±2,86 (6-15)months. Perfluorodecaline was removed a mean 3,28±0,75 (2-4)months after the surgery from 7/10 cases but kept in the eye in other 3 failed cases.
Anatomical success in terms of symmetric and normal external appearances of both eyes was achieved in all cases after the surgery. In 4/10 cases eyes were salvaged with remaining clear lens and attached retina and 3/10 were salvaged as aphakic and attached retina and all had a “fixate and follow” visual acuities yet.Other 3/10 failed cases still filled with decline are still have normal appearance, had clear cornea and normotonic.
Using liquid per-fluorocarbons (decaline) as a mid-term tamponading agent can salvage the otherwise inoperable and lost ROP eyes having combined rhegmatogenous and traction retinal detachments. Neither of these patients appeared to have retinal toxicity. Keeping decaline in the failed eyes even further protects the eyes to progress into phthisis bulbi.