Author: Jean-Paul Berrod, Nancy, France

Advantages:

Quick and easy way to perform PFCL / silicone oil exchange without slippage or subretinal accumulation of fluid in the treatment of giant tears.

Methods:

After vitrectomy we injected PFCL with flute needle under panoramic viewing system till the edge of the tear. Then we disconnect the infusion tubing and continue to inject PFCL until it passes through the disconnected infusion cannula. At this moment we start injecting silicone oil with 7 mm terminal through the temporal superior sclerotomy. Silicone bubble spontaneously positioned between the lens and the superior dome of PFCL bubble as pressure rises in the globe. When the globe is around 20 mmHg, we remove both terminal and replace the silicone cannula in the temporal inferior sclerotomy. PFCL / silicone oil exchange is then conventionally continued under control of Machmer lens with light pipe in one hand and flute needle in the other.

Effectiveness / Safety:

PFCL / silicone oil exchange takes less than 3 minutes with total reattachment of the retina in all cases. Full silicone oil tamponade is obtained.

Take home message:

PFCL / silicone oil exchange may be very simple to succeed.