Perfluorocarbon-perfused vitrectomy using a transconjunctival 25-gauge system

Purpose: To describe the feasibility of perfluorocarbon-perfused vitrectomy (PCPV) using a 25-gauge system in complicated retinal detachment cases. Methods: Thirteen nonconsecutive patients with complicated retinal detachment (either tractional secondary to proliferative diabetic retinopathy or rhegmatogenous) who would not normally be selected for 25-gauge vitrectomy were included in the study. Vitrectomy using 25-gauge ports and perfluorocarbon perfusion was performed. Real vitrectomy time, amount of perfluorocarbon liquid (PCL) used, instrument bending, feasibility of surgical maneuvers using an arbitrary scale, and anatomical and visual results were evaluated. Results: Real vitrectomy time ranged from 6.2 minutes to 17.1 minutes (mean, 10.3 minutes). Amount of PCL ranged from 8 mL to 40 mL (mean, 24.38 mL). Instruments never bent even when using a wide-angle sutured contact lens. All desired maneuvers could be performed and were facilitated by PCL. All retinas were reattached, with two cases of mild recurrent vitreous hemorrhage. Visual acuity improved in 76.9% of eyes. Conclusions: PCPV using a 25-gauge system can be performed, even in complicated cases.