A Short-Time Real-World Study of Two Perfluoropropane Tamponade Methods in Pars Plana Vitrectomy for Retinal Detachment.

INTRODUCTION: This real-world study evaluated the efficacy, safety, and operative parameters of two perfluoropropane (C3F8) tamponade methods combined with pars plana vitrectomy (PPV) for retinal detachment (RD). METHODS: A retrospective study of 132 patients (132 eyes) with RD (pure C3F8 in 38 eyes, mixed C3F8 in 94 eyes). All eyes underwent PPV with C3F8 tamponade and were followed up for at least 3 months. Retinal reattachment rate, time of gas configuration and injection, C3F8 dosage, intraocular pressure (IOP), best corrected visual acuity, postoperative ocular inflammation, and patients' complaints were evaluated. RESULTS: The single-surgery retinal reattachment rates of the pure C3F8 group and mixed C3F8 group were 97.4% and 96.8%, respectively, with no significant difference (p = 1.00). The final retinal reattachment rates of the two groups were 100% and 97.2%, respectively, with no significant difference (p = 1.00). The gas configuration time, gas injection time, and C3F8 dosage were significantly less in the pure C3F8 group (all p < 0.001). Time, but not group, was the influencing factor of postoperative IOP changes in the two groups (p < 0.001, p = 0.547, respectively). Compared with the baseline, the IOP estimates of the pure C3F8 group showed a significant increase immediately after surgery (p < 0.001), and the mixed C3F8 group showed a significant increase immediately and 1-2 days after surgery (all p < 0.05). There was no statistical difference in ocular inflammation (p = 0.339) and patients' complaints of discomfort (p = 0.175) between the two groups. CONCLUSION: Both the two methods of C3F8 tamponade combined with PPV in RD patients showed good efficacy and safety, but the clinical operation of pure C3F8 tamponade was more convenient and eco-friendly.

A pilot study of the precision of digital intraocular pressure measurement during vitrectomy.

AIM: To evaluate the precision of digital intraocular pressure (IOP) measurement in silicone oil (SO) filled eyes during vitrectomy. METHODS: This is a retrospective, single-blind study. Patients who were diagnosed with retinal detachment and scheduled for vitrectomy with SO injection were consecutively enrolled. During the vitrectomy, IOP was digitally measured and then by a rebound tonometer (IcarePRO). The rebound tonometer readings were masked to the surgeons. The digitally measured IOP and that of rebound tonometer were compared, and the inter-methods agreement was assessed. The absolute deviation in IOP values between these two methods (ΔIOP) was also calculated, and correlations between ΔIOP and refractive status, lens status and levels of surgeons' experience were analyzed. RESULTS: A total of 131 patients (131 eyes) were recruited, with a mean age of 51.0±16.1y. There was no significant difference in IOPs between digital measurement and the rebound tonometer (15.6±4.3 vs 15.7±5.1 mm Hg; t=0.406, P=0.686). Intraclass correlation coefficients (ICC) analysis indicated a strong correlation between these two measurements (ICC=0.830, P<0.001). The mean ΔIOP was 2.0±1.9 mm Hg (range: 0-12.8 mm Hg), with 98 eyes (74.8%) had the ΔIOP within 3 mm Hg. ΔIOP was found to be negatively correlated with levels of surgeons' experience (r=-0.183; P=0.037), but not with the refractive status or lens status of the patients (both P>0.05). CONCLUSION: For experienced surgeons, the digital IOP measurement may be an acceptable technique for IOP measurement in SO filled eyes during vitrectomy. However, its use by inexperienced surgeons should be taken with caution.