Subretinal Fluid Drainage through Original Breaks without Perfluorocarbon Liquid for Rhegmatogenous Retinal Detachment

Jong Heon Kim; Kyoo Won Lee; Hyun Gu Kang

doi:10.3341/jkos.2019.60.9.859

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Kim, Lee, and Kang: Subretinal Fluid Drainage through Original Breaks without Perfluorocarbon Liquid for Rhegmatogenous Retinal Detachment

Original Article

Journal of the Korean Ophthalmological Society 2019; 60(9): 859-866.

Published online: 18 September 2019

DOI: https://doi.org/10.3341/jkos.2019.60.9.859

Subretinal Fluid Drainage through Original Breaks without Perfluorocarbon Liquid for Rhegmatogenous Retinal Detachment

Jong Heon Kim, MD, Kyoo Won Lee, MD, PhD, Hyun Gu Kang, MD

Cheil Eye Hospital, Daegu, Korea.

Address reprint requests to Hyun Gu Kang, MD. Cheil Eye Hospital, #1 Ayang-ro, Dong-gu, Daegu 41196, Korea. Tel: 82-53-959-1751, Fax: 82-53-959-1758, flowerchild03@hanmail.net

Received 21 March 2019 Revised 7 May 2019 Accepted 16 August 2019

The Korean Ophthalmological Society

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To evaluate the efficiency of a surgical method using original breaks to drain subretinal fluid without using retinotomy and perfluorocarbon liquid for patients with rhegmatogenous retinal detachment (RRD).

Methods

A retrospective chart review comparing 41 eyes of 41 patients who received vitrectomy, and used original breaks to drain subretinal fluid without using perfluorocarbon liquid, and 40 eyes of 40 patients who received vitrectomy using perfluorocarbon liquid for simple RRD between February 2014 and December 2017 was conducted. All patients were followed for a minimum of 6 months after surgery.

Results

The primary anatomical success percentages were 97.6% and 97.5% for groups that did not and did use perfluorocarbon liquid, respectively. Retinal detachment recurred in one eye from both groups. The final success percentage was 100%. The preoperative mean logMAR best-corrected visual acuity (BCVA) of 0.87 ± 0.80 improved to 0.30 ± 0.30 at postoperative 6 months for the group that did not use perfluorocarbon liquid, while it improved from 0.86 ± 0.71 to 0.42 ± 0.52 for the group that did use perfluorocarbon liquid. Both groups showed significant BCVA improvement (p < 0.01). There was no significant difference in the incidence of complications caused by the use of perfluorocarbon liquid.

Conclusions

Using original breaks to drain subretinal fluid without perfluorocarbon liquid in cases with RRD may be an effective and safe surgical technique for functional and anatomical recovery without serious complications.

Keywords: Original breaks, Perfluorocarbon liquid, Rhegmatogenous retinal detachment, Subretinal fluid, Vitrectomy

Figures and Tables

Figure 1

Summary of vitrectomy without perfluorocarbon liquid. (A) Before fluid air exchange, advanced DSP backflush soft tip is on retinal tear. (B) After fluid air exchange and subretinal fluid drainage through original retinal break, there is remained subretinal fluid at posterior pole. (C) Before endolaser photocoagulation around retinal tear with scleral indentation. (D) After endolaser photocoauglation around retinal tear.

Figure 2

Changes in best corrected visual acuity (BCVA). In group that not used perfluorocarbon liquid (PFCL), preoperative mean logarithm of minimal angle of resolution (logMAR) BCVA was 0.87 ± 0.80. Postoperative mean logMAR BCVA was improved to 0.35 ± 0.31 at 3 months after operation (^p < 0.01) and 0.30 ± 0.30 at 6 months after operation (^p 0.01). In group that used PFCL, preoperative mean logMAR BCVA was 0.86 ± 0.71. Postoperative mean logMAR BCVA was improved to 0.54 ± 0.57 at 3 months after operation (^p = 0.05) and 0.42 ± 0.52 (^p 0.01) at 6 months. There was no significant difference in BCVA between two groups (^†p > 0.05). Values are presented as mean ± standard deviation unless otherwise indicated. ^*The one-way analysis of variance; ^†independent t-test.

Table 1

Preoperative characteristic of patients

Values are presented as mean ± standard deviation or number.

PFCL = perfluorocarbon liquid.

^*Independent t-test; ^†Pearson's chi square test.

Table 2

Preoperative characteristics of retinal break and rhegmatogenous retinal detachment

Values are presented as mean ± standard deviation or number (%).

PFCL = perfluorocarbon liquid.

^*Independent t-test; ^†Pearson's chi square test.

Table 3

Surgical methods

PFCL = perfluorocarbon liquid.

^*Pearson's chi square test.

Table 4

Postoperative results

Values are presented as number (%) or mean ± standard deviation.

PFCL = perfluorocarbon liquid; V.A. = visual acuity; logMAR = logarithm of minimal angle of resolution.

^*Pearson's chi square test; ^†independent t-test.

Table 5

Intraoperative and postoperative complications

Values are presented as number (%).

PFCL = perfluorocarbon liquid; PVD = posterior vitreous detachment.

^*Pearson's chi square test.

Notes

This study was presented as a poster at the 120th Annual Meeting of the Korean Ophthalmological Society 2018.

^{Conflicts of Interest} The authors have no conflicts to disclose.

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