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Anthony Obeid, David Ehmann, Murtaza Adam, Sundeep Kasi, Michael Klufas, Jason Hsu, Sonia Mehta, Allen Chiang, Sunir Garg, Omesh Gupta; Comparison of Residual Subfoveal Fluid by Intraoperative Optical Coherence Tomography After Macula Involving Rhegmatogenous Retinal Detachment Repair Using Direct Drainage, Drainage Retinotomy, or Perfluoro-n-Octane. Invest. Ophthalmol. Vis. Sci. 2018;59(9):4251.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the residual subfoveal fluid (SFF) immediately after various techniques to drain subretinal fluid during rhegmatogenous retinal detachment (RRD) repair using intraoperative optical coherence tomography (iOCT).
Retrospective, interventional, consecutive case series of fovea-involving RRD repaired by pars plana vitrectomy (PPV) with or without a scleral buckle and imaged using iOCT from December 12, 2016 to February 27, 2017. The techniques used to drain subretinal fluid included direct drainage through the primary retinal break, a posterior drainage retinotomy, or perfluoro-n-octane (PFO). iOCT images were acquired through the fovea at the start of the case prior to initiating vitrectomy and then again immediately prior to the introduction of the gas tamponade. For patients receiving PFO, an intraoperative image through the fovea was also taken after the PFO fill. Using ImageJ public domain software (National Institutes of Health, Bethesda, MD) the average SFF thickness was measured with the straight-line function in order to calculate the distance in pixels between the retinal pigment epithelium and the inner retina.
Thirty-one eyes were identified that met the study criteria. Baseline characteristics are summarized in Table 1. Of the 31 eyes, 10 (32.3%) received PFO, 12 (38.7%) underwent a posterior drainage retinotomy, and 9 (29.0%) had drainage through the primary defect. There was no significant difference in the mean SFF thickness between eyes that underwent drainage with PFO (Mean [±SD], 72.1 [±42.1] pixels), drainage retinotomy (Mean [±SD], 65.4 [±29.9] pixels), or drainage through the primary defect (Mean [±SD], 71.0 [±37.3] pixels) (p=0.85) (Figure 1). There was no significant association between SFF thickness on iOCT and functional or anatomical outcomes (p>0.05).
No difference in the amount of residual SFF was found during RRD repair using either PFO, drainage retinotomy, or direct drainage through the primary defect by iOCT. Furthermore, no differences in functional or anatomical outcomes were identified.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
Boxplot graph of subfoveal fluid thickness post fluid-air exchange stratified by PFO, drainage retinotomy, and direct drainage from the primary retinal defect.
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