Wu Liu, MD (Beijing, China), Qian Li, MD (Beijing, China), Yuan He, MD (Beijing, China)

PURPOSE:

Vitrectomy on the floppy retina in eyes with rhegmatogenous retinal detachment (RRD) is always a challenge to retinal surgeons. Here the author introduces a modified technique and its results for vitreous removal during primary vitrectomy treatment for RRD.

METHODS:

Thirty eyes of 30 patients with RRD were treated with perfluorocarbon liquids (PFCL)-sides vitrectomy and the results were analyzed retrospectively. After removal of the detached posterior vitreous by core vitrectomy, PFCL was injected into the vitreous cavity until it covered the residual vitreous on the middle or peripheral retina. The underneath vitreous,
which was positioned by the gravitational force of PFCL, was then removed with vitrectomy. Intraocular maneuver, PFCL consuming, and intra-operative complications associated with this technique were intentionally analyzed.

RESULTS:

The residual vitreous was fairly contoured by the sided PFCL, which facilitates a better visualization. The retina was well stabilized, which allows a closer cutting of the vitreous. Vitreous removal was successful with this technique in each of the 30 eyes. A total of 32 vials (5~7 ml/per vial) of PFCL was needed intra-operatively. Two tiny iatrogenic retinal damages (cutting) were present in two eyes. No subretinal or intravitreal PFCL residue was found postoperatively. After a mean follow-up of 6 months, 29 of the 30 eyes achieved retinal attachment.

CONCLUSION:

PFCL-sided vitrectomy is a safe and easy technique for vitreous removal during vitreoretinal surgery for RDD. Advantages, disadvantages, and skills of this technique will be discussed in detail.