Perfluoro-n-octane as a postoperative vitreoretinal tamponade in the management of giant retinal tears

Background: Despite recent advances in giant retinal tear repair, retinal redetachment remains an issue. This may be due to inadequate retinal tamponade with silicone oil or perfluorocarbon gas that allows fluid to seep back under the edge of the tear. We propose short-term postoperative retinal tamponade with perfluoro-n-octane liquid to overcome this problem. Theoretical advantages include the reduced likelihood of proliferative vitreoretinopathy. It is easier to remove than silicone oil due to its lower viscosity, and supine posturing is more manageable from a patient perspective. Methods: A retrospective case series of 16 giant retinal tear repairs without significant proliferative vitreoretinopathy is presented. Lens-sparing vitrectomy was performed with endolaser to the edge of the tear and the entire retinal periphery. Scleral buckling was not utilized. Perfluoro-n-octane was used as a postoperative tamponade for a mean of 16.4 days (range, 6-50 days). Results: The retina was reattached at the end of the procedure in all 16 cases. Redetachment occurred in only 1 (6.3%) of 16 cases. Conclusion: Postoperative tamponade with perfluoro-n-octane may decrease the rate of redetachment in giant retinal tear repair compared with silicone oil or perfluorocarbon gas alone. We found no adverse effects directly attributable to perfluoro-n-octane