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I use sulfur hexafluoride SF6 20%. We need to have a non expansile gas without hypotony.

My way:

  • I do a complete fluid air exchange to have an air filled globe.
  • Then I remove all trocars from air filled globe except the infusion cannula.
  • I fill a 5cc syringe with 2cc SF6 and 3cc air (SF6 40%).
  • I fit a 28 G needle to the gas syring.
  • I insert the needle in the upper sclera at 12 o’clock and hold it in place with right hand.
  • Then I remove the infusion trocar with a clamp held by the left hand, and the assistant immediately presses on the wound with a Q tip.
  • Then I hold the Q tip with my left hand and do wound massaging as usual until sure of wound coaptation.
  • Then I inject the gas in the air filled eye.

Advantages:

  • More complete gas fil.
  • No Hypotony after removal of trocar.
  • Safe easy needle insertion for gas injection (no hypotony).

Disadvantages:

  • Elevated intraocular pressure in some cases.
  • Well trained assistant for proper rapid wound massaging and stabilization when I regrasp the Q tip.