Purchase this article with an account.
R.K. Shuler, Jr., M. Stopa, K. Winter, M. McCall, C.A. Toth; Hyperosmolar Infusion Fluid Fascilitates Surgical Retinal Detachment . Invest. Ophthalmol. Vis. Sci. 2006;47(13):4682.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Retinal detachment can be a challenging maneuver in macular translocation surgery. We aim to determine if hyperosmolar infusion fluid facilitates the surgical creation of retinal detachment in a rabbit model. Further we aim to investigate the lower limit of infusate osmolarity that aids in retinal detachment.
Pars plana vitrectomy was utilized to remove the axial and cortical vitreous in 13 adult rabbits (26 eyes). Control infusion fluid (osmolarity 298–308 mOsM) and experimental NaCl solutions (osmolarities of 1000, 500, 400, 370, 350, 340, 330, and 320 mOsM) were evaluated in a masked fashion. Outcome criteria included retinal bleb formation, ability to mechanically separate neurosensory retina from the RPE, ability to slide the retina using a Tano scraper, nature of fluid spread with subretinal injection.
Spontaneous bleb formation occurred in less than 10 minutes using 370 mOsM or greater infusate. Larger blebs and shorter time to bleb formation were evident with increasing osmolarity. Retinal sliding with the Tano scraper was possible with infusate osmolarity of 340 mOsM or greater. Fluid injected into the subretinal space spread in a low diffuse fashion versus a highly–domed, localized fashion with 340 mOsM or greater infusate.
There appears to be a dose response curve regarding increasing infusion fluid osmolarity and ease of separating the rabbit neurosensory retina from RPE. The lower limit of infusion fluid osmolarity that aids in surgical detachment of the rabbit retina appears to be 340 mOsM. Future studies are planned to determine the safety of this osmolarity on the structure and function of a euangiotic retina.
This PDF is available to Subscribers Only