Abstract
PURPOSE: Perfluorocarbon liquid (PFCL) tamponade is increasingly used in vitrectomy for complex retinal disorders. However, its effectiveness, indications, and safety remain uncertain. This study aimed to systematically evaluate the clinical outcomes, safety, and indications of medium-term PFCL tamponade in vitrectomy for complex retinal disorders based on the existing literature. METHODS: A systematic review was conducted following PRISMA 2020 guidelines. PubMed, Google Scholar, and Web of Science were searched for English-language studies (2005‒2025) reporting vitrectomy with postoperative medium-term PFCL tamponade for retinal detachment (RD) or open globe injury. Case reports, conference abstracts, commentaries, non-English publications, studies involving pediatric populations, studies with ≤ 10 eyes, and studies with potentially overlapping patient cohorts were excluded. Study quality was assessed using the Joanna Briggs Institute (JBI) checklist. Random-effects single-arm meta-analyses were applied for redetachment rates and visual improvement rates. RESULTS: Seventeen studies comprising 775 eyes were included. Substantial heterogeneity was observed. The pooled redetachment and visual improvement rates were 8.49% and 74.91%, respectively. Common complications included cataract progression, elevated intraocular pressure, transient ocular hypertension, and deposit formation. However, most included studies were retrospective case series, and heterogeneity in study design and outcome definitions limited the interpretation of the pooled results. CONCLUSIONS: Medium-term PFCL tamponade may be a viable alternative or adjunct to silicone oil in selected complex RD cases, with favorable anatomical and visual outcomes. However, evidence is limited by retrospective designs, lack of control groups, heterogeneity, and biases. Further prospective comparative trials are necessary to validate these roles in clinical practice. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s40942-026-00814-5.