Ocular tolerance and efficacy of short-term tamponade with double filling of polydimethyloxane and perfluoro-n-octane

Stefano Zenoni¹, Mario R Romano², Sonia Palmieri¹, Natalia Comi¹, Edoardo Fiorentini¹, Piero Fontana^1
1Ospedali Riuniti di Bergamo, Bergamo, Italy; ²Istituto Clinico Humanitas IRCSS, Rozzano, Milan, Italy

Objective: The aim of the study was to evaluate the ocular tolerance and efficacy of double filling with perfluoro-n-octane (n-C8F18) (PFO) and polydimethyloxane (PDMS) as a temporary vitreous substitute in patients with retinal detachment complicated by proliferative vitreoretinopathy (PVR).
Material and methods: Tamponade was performed in 30 eyes of 30 patients by double filling with 30% PFO and 70% PDMS for an average of 23 (standard deviation 2.2) days. The follow-up visits were scheduled 1 week, 1 month, and 3 months after surgery. The main outcome measures were visual acuity, intraocular pressure (IOP), PVR reproliferation, and electrophysiological parameters.
Results: The primary success rate was 80% (24/30). Fourteen patients (46.7%) had a postoperative improvement in visual acuity, 12 patients (40.0%) maintained their preoperative visual acuity, and four patients (13.3%) experienced a reduction in visual acuity. The mean postoperative IOP was 19.7 mm Hg (11–32 mm Hg); nine cases (30.0%) developed an IOP increase that was treated with topical drops and/or systemic carbonic anhydrase inhibitors. The electroretinogram (ERG) and the bright flash electroretinogram (bf ERG) parameters showed a statistically significant difference of means between 4- and 8-week follow-up visits.
Conclusion: Our experience with double filling in selected cases of retinal detachment has been positive. No electroretinographic signs of retinal toxicity and a low incidence of PVR reproliferation were observed.

Keywords: double filling, proliferative vitreo-retinopathy, perfluoro-n-octane, polydimethyloxane, retinal detachment, retinal detachment electrophysiology