Cesare Forlini, MD*, Giacoma Lorusso, MD, Roberto Lodi, MD, Marco Moretti, MD, Giuseppe Giunchiglia, MD, Massimo Ambesi, MD Italy
To evaluate the use of double tamponade in advanced PVR when it is necessary to perform a wide retinotomy
We present an advanced PVR case after complications of previous episcleral surgery and haemorrhagic choroidal detachment.After via pars plana vitrectomy and circular retinotomy we removed the subretinal haematoma and subretinal membranes. The choroidal tear was tamponade by an ab externo buckling which allows the retina to be replaced on the choroid under a F6H8 tamponade which is used as a heavy liquid. Endolaser is performed and silicone oil is injected in order to obtain a double tamponade with 70% of F6H8. We suggest the patient to sit or to lie on his back so that the tamponade is more effective. After 47 days the tamponade is removed.
The ab externo buckling closed the choroidal tear. At the end of the surgery the retina appears attached.
Thanks to the use of double tamponade, we can achieve good results after wide retinotomies and in particular in inferior sectors where the greater specific weight prevent the growing of membranes. The emulsion of the double tamponade bubble neither leaves remains nor causes damages on the retina. The double tamponade allows us to achieve an anatomic result reducing proliferative stimuli in severe PVR cases. The patient’s compliance is improved because he does not have to take uncomfortable positions as when using gases.
Take home message:
The double tamponade was useful for reattaching the retina avoiding inferior recurrence and improving the patient’s compliance without secondary complications.