An interventional study of Perflurocarbon liquid and Without Perflurocarbon liquid in Retinal Displacement After Retinal Detachment Surgery, sponsored by Norfolk and Norwich University Hospitals NHS Foundation Trust. Recruiting at 1 site in United Kingdom. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-04-14.
Sponsored by Norfolk and Norwich University Hospitals NHS Foundation Trust · Not applicable, Interventional, and Treatment
Rhegmatogenous retinal detachment (RRD) is an acute, sight threatening condition, with an incidence of approximately 10 per 100,000 people. Surgical interventions for treating RRD include pars plana vitrectomy (PPV), which currently represents the main adopted surgical choice. Main outcomes of successful RRD surgery have mainly been represented by anatomical retinal reattachment and best-corrected visual acuity (BCVA). Despite successful surgery, patients with mac-off RRD often report postoperative visual complaints of distortion such as metamorphopsia and scotomas in their central visual field, with great variability.
Major advances in retinal imaging including wide-field optical coherence tomography (OCT) and fundus autofluorescence (FAF) allowed to investigate morphological changes after RRD surgery. The concept of retinal displacement - where the retina has reattached but the exact location has shifted, as evidenced by retinal vessel printing shown on post operative retinal imaging.
Postoperative retinal displacement has been observed to occur with different frequency in relationship to variables including postoperative tamponade, surgical technique, and intraoperative use of perfluorocarbon liquids (PFCL). The investigators hope to formally study the impact of intraoperative use of PFCL, which is used as an aid during surgery to help flatten and position the retina, on retinal displacement. This will help us better understand the impact of this tool on outcomes both objectively through retinal imaging, and subjectively through visual outcomes including visual acuity and measures of distortion and other visual disturbances.
Rhegmatogenous retinal detachment (RRD) is an acute, sight threatening condition, resulting from the separation of the neurosensory retina from the underlying retinal pigment epithelium (RPE). It is caused by at least one retinal break and recruitment of intraocular fluid into the subretinal space. Surgical interventions for treating RRD include pars plana vitrectomy (PPV), which currently represents the most widely adopted surgical choice, scleral buckling (SB) and pneumatic retinopexy (PnR).
Significant visual loss is the main complaint of patients with macula-involving RRD (MIRD). Hence, the main outcomes of successful RRD surgery have historically been represented by postoperative anatomical retinal reattachment and best-corrected visual acuity (BCVA). However, despite successful surgery, patients with MIRD often report postoperative visual complaints of distortion such as metamorphopsia, aniseikonia and scotomas in their central visual field, with great variability.
Major advances in retinal imaging contributed to provide a better understanding of postoperative visual complaints after surgery for RRD. In particular, optical coherence tomography (OCT) highlighted drop-out of the ellipsoid zone (EZ) or outer and inner retinal folds in the macula area. However, only more recently, hyperautofluorescent lines, also called Retinal Vessel Printing (RVP), adjacent to the retinal blood vessels, were noted on autofluorescence imaging in patients who underwent RRD surgery. This finding is believed to be secondary to unintentional retinal displacement after RRD surgery and may serve as a surrogate anatomical marker of postoperative metamorphopsia and central scotomas.
Postoperative retinal displacement is potentially influenced by several variables including intraocular tamponade, adopted surgical technique, intraoperative use of perfluorocarbon liquids (PFCL) and postoperative posture. The effect of PFCL on retinal displacement is currently unknown due to lack of RCTs and significant limitations of previous research. Therefore, the aim of this RCT is to investigate the role of intraoperative PFCL on postoperative retinal displacement in patients with MIRD undergoing PPV with immediate postoperative face-down posture.
The investigators aim to evaluate whether intraoperative PFCL affects the incidence and patterns of postoperative retinal displacement. As secondary outcomes, this RCT will also investigate the effect of intraoperative use of PFCL on functional outcomes, e.g. BCVA, metamorphopsia and aniseikonia. All patients participating in the trial will be randomly allocated to having surgery either with or without the use of PFCL, and will be followed up regularly after surgery for up to 6 months.
199 studies on the registry are indexed under Retinal Detachment; 29 are open to participants now.
This study's planned enrollment of 292 is above the median of 50 across 132 interventional studies indexed under Retinal Detachment.
Browse Retinal Detachment studies →Norfolk and Norwich University Hospitals NHS Foundation Trust is the lead sponsor of 30 studies on the registry; 9 are open to participants now.
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Informed consent
Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.
You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.
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A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.
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Standard retinal detachment surgery (vitrectomy) with the use of Perflurocarbon liquid (PFCL) to stabilise macular during surgery and drainage of subretinal fluid. PFCL is then fully removed before the end of surgery.
Procedure: Perflurocarbon liquid
Standard retinal detachment surgery (vitrectomy) without the use of Perflurocarbon liquid (PFCL).
Procedure: Without Perflurocarbon liquid
Used to facilitate surgery of retinal detachment to stabilise macular during surgery.
Standard retinal detachment surgery (vitrectomy) without the use of Perflurocarbon liquid (PFCL).
Retinal Displacement
Number of patients with presence of retinal displacement on post operative retinal imaging (FAF) between groups with PFCL use and without PFCL use.
Time frame: 3 months post operation
Best-Corrected Visual Acuity
Average change in visual acuity (BCVA) in groups with PFCL and without PFCL use
Time frame: Baseline, 2 weeks, 3 months, and 6 months (at discretion of research team, see protocol)
Metamorphopsia
Average M-CHARTS score comparison between groups with PFCL use and without PFCL use.
Time frame: 3 months post operation
Quantification of retinal displacement
Retinal displacement distance as measured on retinal imaging (FAF) in millimetres.
Time frame: 3 months post operation
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Norfolk and Norwich University Hospitals NHS Foundation Trust