Abstract
Purpose: To develop a simple tool to remove retained sub-macular PFCL bubbles (R-PFCL), and to inject rt- Plasminogen Activator(rt-PA) safely in sub-retinal space in sub-macular hematomas (SMH). Method: A retrospective, interventional study was performed where we developed a simple homemade Micro-VFC to gain access to sub-retinal space in a controlled way. We cut the rubber cap of the plunger of a 1ml syringe and this cut rubber cap of the plunger was fitted inside an empty 1 ml tuberculin syringe and its end was fitted with the tubings of VFC of the vitrectomy machine. Now VFC mode was activated attaching a 38G/41G sub-retinal needle for extracting sub-macular PFCL bubbles (R-PFCL group, n=12) and to deliver rt-PA injection in significant SMH cases (SMH group, n=32). BCVA, fundus photograph and OCT were analysed. Follow-up was done for at least 6 months. Results: Vision improved from preoperative mean BCVA LogMAR 0.99(20/195) ± 0.27 to post-operative mean BCVA LogMAR 0.75(20/112) ± 0.21 (p-value <0.05) in R-PFCL group and from preoperative mean BCVA LogMAR 1.99(20/1954) ± 0.75 to post-operative mean BCVA LogMAR 0.75(20/112) ± 0.37 (p-value <0.001) in SMH group. Conclusion: Our homemade Micro-VFC is a safe tool to extract retained sub-macular PFCL bubbles and to deliver a precise dose of sub-retinal drugs like rt-PA for a sub-retinal hematoma in a controlled way.
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