Comparison of perfluorocarbon liquid utilization in endoscopic pars plana vitrectomy and microscopic pars plana vitrectomy during retinal detachment repair: a retrospective review

TL;DR

This study compares the use of a special liquid during two types of eye surgery for retinal detachment and finds it is used more often in one method.

Contribution

The study reveals that perfluorocarbon liquid is used more frequently in endoscopic vitrectomy compared to standard vitrectomy.

Findings

PFO was used in 38.75% of endoscopic cases versus 26.79% of standard cases.

There was no significant difference in retinal re-detachment rates between the groups.

PFO use was associated with worse preoperative visual acuity.

Abstract

Retinal detachment (RD) is a vision threatening condition that often requires surgical intervention. During RD repair, perfluorocarbon liquid (PFCL) use, such as perfluoro-n-octane (PFO), can be used as a retinal tamponade source. However, PFO use adds additional cost and may lead to complications like inflammatory response. Pars plana vitrectomy (PPV) can be done the standard method using a surgical-microscope PPV (S-PPV) or with endoscopic PPV (E-PPV) in cases of hazy anterior view. The purpose of this study is to compare PFO use and outcomes between E-PPV and S-PPV for RD repair.

A retrospective chart review of patients undergoing RD repair between August 2017 and July 2023 at a tertiary referral center was performed. Patients were included if they had a minimum of 6-months postoperative visits. Data was collected for patient demographics, visual acuity (VA), intraocular pressure (IOP), procedure details, and surgical outcomes. Statistical analysis was performed using t-tests and chi-square analysis. This study was approved by our institutional review board (IRB).

401 patients met the inclusion criteria with an average age of 59.17 (SD = 14.66). Of those included, 38.15% were female and 61.85% were male. PFO was utilized in 29.18% (N = 117) of cases. Most procedures performed were S-PPV (80.05%, N = 321) with the remaining cases being E-PPV (19.95%, N = 80). PFO was utilized in 38.75% of E-PPV cases, but in only 26.79% of S-PPV cases (p = 0.035). There were some variations in VA and IOP outcomes, with the PFO group generally having worse preoperative visual acuity. There were no statistically significant differences in rates of retinal re-detachment, cystoid macular edema (CME), or epiretinal membrane (ERM) development between any of the groups.

In this study, PFO was used more frequently in those undergoing E-PPV compared to S-PPV. With PFO use, there was no statistically significant difference in re-detachment rate between the E-PPV and S-PPV groups. PFO use may be more beneficial in patients with poor anterior view given its higher utilization rate in E-PPV.

The online version contains supplementary material available at 10.1186/s40942-026-00802-9.