Internal Drainage Of Subretinal Fluid Research Articles

Intraoperative Perfluorocarbon Liquids in the Management of Proliferative Vitreoretinopathy

Three low-viscosity perfluorocarbon liquids were used intraoperatively for hydrokinetic manipulation of the retina during vitreous surgery for retinal detachment with advanced proliferative vitreoretinopathy. All 23 patients had massive proliferative vitreoretinopathy (Grade D, Retina Society classification), and 16 (69.6%) had Grade D-3 with a closed-funnel configuration. In 21 eyes the retina could be flattened intraoperatively by perfluorocarbon liquids without requiring posterior retinotomy for internal drainage of subretinal fluid. The temporary mechanical fixation of the retina provided by this tool facilitated the removal of epiretinal membranes and release of traction. Fifteen eyes (65.2%) maintained long-term retinal reattachment with follow-up of six months or more. These liquids are useful adjuncts in the management of retinal detachment with severe proliferative vitreoretinopathy.

Low Viscosity Liquid Fluorochemicals in Vitreous Surgery

Low viscosity liquid fluorocarbons have physical properties potentially useful as intraoperative adjuncts during vitreous surgery for complicated retinal detachments. These substances are optically clear, have specific gravity greater than that of water, and interfacila tension properties similar to those of silicone oil. In four patients who had complicated retinal detachments I used perfluorotributylamine and perfluorodecalin during vitreous surgery. Two giant retinal tears were flattened intraoperatively without turning the patient into the prone position. In two patients with severe proliferative vitreoretinopathy, perfluorotributylamine allowed adequate retinal tamponade and avoided a posterior retinotomy for internal drainage of subretinal fluid. Endophotocoagulation was applied.

The treatment of macular holes by pars plana vitrectomy and internal air/SF6 exchange.

The results of a series of patients with full-thickness macular holes treated by pars plana vitrectomy are described. A air/gas mixture is used to tamponade the retinal hole and no adhesion is applied. Eleven eyes, including six high myopes, were treated using this method and sustained reattachment was achieved in eight eyes (73%). Three cases failed due to the presence of preretinal membrane formation and retinal shortening. This method is technically easy, allows good tamponade of the retinal hole with controlled internal drainage of subretinal fluid, and appears much safer than previously described techniques.

An illuminated suction needle for air-fluid exchange after vitrectomy.

We have developed an illuminated suction needle for air-fluid exchange and internal drainage of subretinal fluid. When combined with an indirect ophthalmoscope, this instrument simplifies these intraoperative maneuvers in air-filled phakic eyes.