MINIMAL GAS VITRECTOMY TECHNIQUE FOR REDUCING RISK OF RETINAL DISPLACEMENT FOLLOWING RHEGMATOGENOUS RETINAL DETACHMENT REPAIR.

Abstract

To present a novel technique, minimal gas vitrectomy, as a means of potentially minimizing retinal displacement compared with standard vitrectomy for select cases. A patient with a macula off retinal detachment and break at 12 o'clock underwent a 23-gauge pars plana vitrectomy, endodiathermy of the superior break in detached retina and endolaser of the inferior break in attached retina, without air-fluid exchange. Suturing of sclerotomies, anterior chamber paracentesis of 0.3 mL followed by intravitreal injection of 0.6 mL pure SF 6 was then performed. Positioning was face down for 6 hours and then steamroll up with laser retinopexy to the superior break the following day. Postoperative fundus autofluorescence imaging demonstrated no retinal displacement. The minimal gas vitrectomy technique has the potential to minimize retinal displacement by using a smaller gas tamponade compared to standard vitrectomy in certain cases with specific postoperative positioning instructions.