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Methods:

I don’t perform a direct heavy liquid silicone oil exchange I do: active peripheral suction over the heavy liquid bubble, then start air infusion while staying in the interface. Then I go with the Vitrectomy probe to the heavy liquid bubble, and keep shifting between the bubble and the interface till I have a complete air fill. Then I inject silicone oil via upper trocar using a 23G viscous fluid canula. During silicone oil injection, the air infusion is gradually reduced.

Advantages:

  • Sure complete retinal reattachment without hidden peripheral cuff of Subretinal fluid.
  • No retained heavy liquid bubbles
  • Air fill allows for: complete basal vitreous shaving, proper laser around retinal breaks and 360 laser, with a wider field of vision.
  • Can be used with Giant retinal tears GRT without slippage of the edge