Tamponade in surgery for retinal detachment associated with proliferative vitreoretinopathy

Background: Retinal detachment (RD) with proliferative vitreoretinopathy (PVR) often requires surgery. During surgery, a tamponade agent is needed to reduce the rate of recurrent retinal detachment. Objectives: The objective of this review was to evaluate the benefits and adverse outcomes of surgery with various tamponade agents. Search strategy: We searched the Cochrane Controlled Register (CENTRAL), MEDLINE, EMBASE, Latin America and Carribbean Health Sciences (LILACS) and the UK Clinical Trials Gateway (UKCTG). There were no language or date restrictions in the search for trials. The electronic databases were last searched on 9 July 2009. Selection criteria: We included randomized clinical trials comparing patients treated with various tamponade agents. Data collection and analysis: Two individuals screened the search results independently. One study with two trials was eligible for inclusion in the review. Main results: One study with two trials was included in the review. The first trial randomized 151 eyes to receive either silicone oil or sulfur hexafluoride (SF6) gas tamponades; the second trial randomized 271 eyes to receive either silicone oil or perfluropropane (C₃F₈) gas tamponades. In patients with RD associated with PVR, pars plana vitrectomy and infusion of either silicone oil or perfluropropane gas appear comparable for a broad variety of cases. Sulfur hexafluoride gas was associated with worse anatomic and visual outcomes than either silicone oil or perfluropropane gas. Authors' conclusions: The use of either C₃F₈ or silicone oil appears reasonable for most patients with RD associated with PVR. Because there do not appear to be any major differences in outcomes between the two agents, the choice of a tamponade agent should be individualized for each patient.