After perfoming central vitrectomy, I inject perfluro-carbon liquid (PFCL) into the vitreous cavity, to re-attach retina, up to the level of the retinal breaks. If there are no detectable breaks, I inject the PFCL as peripheral as possible up to the level of the posterior border of the vitreous base. Subsequently, air is infused, to fill the anterior part of the vitreous cavity.

At the air level: I perform meticulous shaving of the vitreous base, 360 degrees laser, and peripheral retinectomy if needed. Then, I perform air/ PFCL exchange, to fill the whole vitreous cavity with air. I end up with one of the following options for endotamponade: silicone oil injection under air, gas injection or air augmentation.

Advantages:

Working under air enhances safe and complete vitreous base shaving and allows peripheral 360 degrees laser application up to the ora serrata. This minimizes the need for retinectomy and renders perfomance of retinectomy safer with decreased bleeding should it be required.

Disadvantages:

Air may obscure visualization, especially if it migrates into the anterior chamber. However, adaptation is rather easy and filling the anterior chamber with an ophthalmic viscoelastic device minimizes air migration.

Contact Details:

Email: waelewais74@gmail.com
Cell Phone: +201223638643

Wael Ewais