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Tadashi Hasumura, Naoko Yonemura, Akira Hirata, Yasuhiro Murata, Akira Negi; Retinal Damage by Air Infusion during Vitrectomy in Rabbit Eyes. Invest. Ophthalmol. Vis. Sci. 2000;41(13):4300-4304.
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purpose. Visual field defects after vitrectomy can be seen after any surgery
involving fluid–air exchange. To elucidate the effect during surgery
of the infused air on the retina, the present study investigated the
changes in the morphology of the rabbit retina induced by air infusion
and the changes resulting from varying amounts of infused air pressure.
methods. Eighteen eyes of 18 rabbits were used. A standard three-port vitrectomy
with artificial posterior vitreous detachment followed by fluid–air
exchange was performed in 12 eyes. During the fluid–air exchange,
humidified air was infused with an air pressure of 25 or 40 mm Hg for
30 seconds. As a control, vitrectomy without fluid–air exchange was
performed in six eyes. The eyes were enucleated and fixed immediately.
Specimens were processed and examined by light and scanning electron
results. With SEM, sharply demarcated retinal lesions were observed at the
opposite side from the infusion cannula in all eyes in which a
fluid–air exchange was performed. At the lesion, the internal limiting
membrane was often detached, and the underlying nerve fiber layer was
exposed. Light microscopy revealed that the inner retina was most
affected, with concomitant swelling of the inner plexiform layer and
the inner granular layer. In addition, the retina was often focally
detached with adhesion of some retinal pigment epithelial cells to the
photoreceptor cells. Increased infused air pressure was accompanied by
a significant increase in the area of retinal damage. In contrast, no
morphologic change was observed in the control eyes.
conclusions. Air infusion during vitrectomy can cause mechanical retinal damage in
the rabbit retina. The mechanical damage may result in a visual field
defect after vitrectomy.
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