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

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.