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Frank Faude, Susanne Wendt, Bernd Biedermann, Ulrich Gärtner, Johannes Kacza, Johannes Seeger, Andreas Reichenbach, Peter Wiedemann; Facilitation of Artificial Retinal Detachment for Macular Translocation Surgery Tested in Rabbit. Invest. Ophthalmol. Vis. Sci. 2001;42(6):1328-1337.
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purpose. For macular translocation surgery, the native attached retina has to be
detached either locally or completely. Although different surgical
techniques are used, there is a general search for supporting
procedures that facilitate and accelerate the retinal detachment.
methods. Pars plana vitrectomies were performed in pigmented rabbits. In all
experimental groups, a local retinal detachment was created by infusing
the test solution with a thin glass micropipette attached to a glass
syringe. In control animals a standard balanced salt solution was used
at room temperature, in combination with a standard vitrectomy light
source. In two test groups, a calcium- and magnesium-free solution was
used for the vitrectomy, under illumination by a standard light source
in group I (solution at room temperature) and group II (solution heated
up to body temperature). In group III the rabbits were dark-adapted for
half an hour, and then, during surgery, a red filter was used in front
of the light source (standard balanced salt solution at room
temperature). After the rabbits were killed at the end of surgery, the
adherence of the retinal pigment epithelium (RPE) to the neural retina
in the detachment area was quantified microscopically, and the
morphologic integrity of the detached retinal tissue was examined by
light and electron microscopy. No electrophysiology was performed.
results. In all four groups, it was possible to detach the retina. The maximum
adherence of the RPE cells to the neural retina was observed in the
control group. Virtually no decrease in adherence was found in test
group II (36°C solution without calcium and magnesium), whereas a
significant decrease was seen in both group I (calcium- and
magnesium-free solution at room temperature) and group III (dark
adaptation–red light technique; standard balanced salt solution at
room temperature). In none of the experimental groups was any obvious
damage of the retinal structure observed, even after exposure to the
test solutions for 60 minutes.
conclusions. Both dark adaptation (red illumination) and the use of a calcium
chloride– and magnesium chloride–free solution (at room temperature)
can facilitate retinal detachment in macular translocation surgery.
Both techniques are proposed as a gentle support for the operation,
because they protect an intact RPE cell layer and do not cause retinal
damage at the ultrastructural level.
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