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Randomized Controlled Trial
. 2025 Aug 19;25(1):476.
doi: 10.1186/s12886-025-04271-w.

Outcomes of perfluorocarbon liquid vs. posterior retinotomy as adjuncts during pars-plana vitrectomy for the surgical repair of rhegmatogenous retinal detachment: a randomized clinical trial

Ehab Mohamed Elsayed Saad  1 , Hazem Elbadry Mohammed Mohammed  2 , Mohamed Mohamed-Aly Ibrahim  2 , Omar Hassan Salama Selim  2 , Sayed Mostafa Elsayed Abdelhafeez  2 , Ahmed Mohammed Sakr  2 , Fathy Mohamed Abo Elftouh Elsalhy  2 , Ahmed Abdelmohsen Ali Ayoub  2 , Ehab Abdelsamea Alazab  2 , Ehab Tharwat  3 , Tamer Gamal El Sayed Mostafa  4
Affiliations
Randomized Controlled Trial

Outcomes of perfluorocarbon liquid vs. posterior retinotomy as adjuncts during pars-plana vitrectomy for the surgical repair of rhegmatogenous retinal detachment: a randomized clinical trial

Ehab Mohamed Elsayed Saad et al. BMC Ophthalmol. .

Abstract

Purpose: Rhegmatogenous retinal detachment (RRD) is a sight-threatening condition requiring prompt surgical intervention. Various adjunctive techniques are employed to enhance subretinal fluid drainage and retinal reattachment. This study aimed to evaluate the outcomes of perfluorocarbon liquid (PFCL) versus posterior retinotomy (PR) during pars plana vitrectomy (PPV) for RRD, focusing on anatomical success, visual acuity, intraocular pressure (IOP), and complications.

Methods: This is a prospective randomized controlled trial that included 58 eyes with RRD, divided into Group A (PFCL, n = 29) and Group B (PR, n = 29). Preoperative assessments included best-corrected visual acuity (BCVA), IOP, axial length, lens status, macula status, and PVR grade. Outcomes were evaluated at 1 week, 1 month, 2 months, and 3 months postoperatively. Primary outcomes included retinal reattachment rates and the number of operations; secondary outcomes included BCVA, IOP changes, complications like cataract development, retinal redetachment, epiretinal membrane (ERM) formation, and single-surgery success.

Results: Retinal reattachment rates were comparable (76% in Group A vs. 66% in Group B, p = 0.387), as well as the number of operations (p = 0.375). Moreover, BCVA improved significantly in both groups (p < 0.05), with no intergroup differences. IOP increased postoperatively in both groups (p < 0.001), with no significant differences. No differences were observed in cataract formation or retinal redetachment. However, ERM incidence was significantly higher in the PR group (27% vs. 11%, p = 0.049).

Conclusion: PFCL and PR are effective for RRD repair, with similar anatomical and visual outcomes. However, PFCL may reduce ERM risk, making it preferable in certain cases. These findings guide surgical decision-making and highlight the need for further research.

Trial registration: The study was retrospectively registered at ClinicalTrials.gov (NCT06919211) on April 4, 2025.

Keywords: Epiretinal membrane; Pars plana vitrectomy; Perfluorocarbon liquid; Posterior retinotomy; Rhegmatogenous retinal detachment.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: This study was conducted following the principles of the Declaration of Helsinki and was approved by the Institutional Review Board (IRB) of the Faculty of Medicine, Al-Azhar University (Approval No. [Ophth._19/2024Med.Research]), Cairo, Egypt. Written informed consent was obtained from all participants before enrollment. Consent for publication: All authors have reviewed and approved the final manuscript for publication. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
A Intraoperative photograph of a rhegmatogenous retinal detachment (RRD) case during diathermy application to the primary retinal tear. B Intraoperative image of the same case following perfluorocarbon liquid (PFCL) injection, with endolaser photocoagulation being applied around the retinal break
Fig. 2
Fig. 2
Intraoperative photo showing posterior retinotomy (PR) created using diathermy for SRF drainage in a case of RRD (Group B)
Fig. 3
Fig. 3
Changes in BCVA in PFCL Group and PR Group at preoperative, 1 week, 1 month, 2 months, and 3 months postoperative time points
Fig. 4
Fig. 4
Incidence of Epiretinal Membrane Development in the Studied Groups
See this image and copyright information in PMC

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