Vitrectomy Under Air: Technique, Advantages & Disadvantages



To describe and evaluate vitrectomy under air for a variety of vitreoretinal surgical indications in a non-randomized prospective interventional case series.


After initial posterior vitreous detachment, (PVD) core vitrectomy, and early air-fluid exchange, the rest of the vitrectomy was performed under air. Visibility of the vitreous gel, field of view, retinal safety, retinal and vitreous cavity stability, and complications were evaluated for rhegmatogenous retinal detachment, vitrectomy for diabetic vitreous hemorrhage and tractional retinal detachment, and macular hole surgery. vitrectomy machine setup including cut rate, vacuum and duty cycle settings were adjusted and modified to promote efficiency and safety while using this technique.


A wider field of view was beneficial in cases of narrow pupils and allowed far anterior vitrectomy with more efficient vitreous base shaving. Stabilizing the highly mobile retina in cases of rhegmatogenous retinal detachment using air resulted in a more efficient and safer vitrectomy close to the retinal surface. Hemostasis at sites of oozing epicenters in diabetic vitrectomy was achieved under air, allowing greater visibility. Limited peripheral retinectomies were performed safely under air without The use of perflurocarbon liquids (PFCL). Internal limiting membrane (ILM) peeling was possible under air and provided retinal stability in cases of macula off retinal detachment. Visibility may be an issue under air in pseudophakic patients with open posterior lens capsule.


Vitrectomy under air appears safe with several advantages over vitrectomy under BSS for different vitreoretinal surgical indications.


Mohamed Moghazy Mahgoub
Cairo, Egypt
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