Abstract
Abstract: :
Purpose: Subfoveal perfluorocarbon liquid has been shown to cause irreversible photoreceptor damage in a very short time. We report a case in which subfoveal perfluorocarbon liquid was removed 11 weeks after initial surgery with significant visual recovery. Methods: A 41-year-old high myope presented with acute loss of vision to hand motion in his right eye. A diagnosis of dense vitreous hemorrhage with bullous, macula-splitting rhegmatogenous retinal detachment was made with the help of ultrasonography. The patient underwent pars plana vitrectomy, placement of scleral buckle, perfluorocarbon liquid injection, endolaser, perfluorocarbon liquid-air exchange and injection of 16% perfluoropropane (C3F8) gas. The patient missed his six-week post-operative appointment, and when he was finally seen 11 weeks following vitrectomy, the best-corrected visual acuity had improved to 20/400 with completely attached retina and less than 5 % gas bubble. However, he was noted to have an 800-micron, perfectly centered subfoveal perfluorocarbon liquid bubble. Repeat pars plana vitrectomy was performed during which the macula was redetached using macular translocation techniques and the perfluorocarbon liquid bubble was removed. Results: At 3-month follow-up, the visual acuity had improved to 20/70. On examination, subfoveal pigmentary changes were noted on clinical and fluorescein angiography in the area of the removed perfluorocarbon liquid bubble. The retina remained completely attached. Conclusions: Although early recognition and prompt removal of inadvertent subfoveal perfluorocarbon liquid is recommended, relatively delayed removal, as in the present case, may still result in significant visual recovery.
Keywords: retinal detachment • vitreoretinal surgery • vitreous substitutes