Abstract
Purpose :
To present an effective surgical approach to remove submacular perfluorocarbon fluid (PFCL) with minimal surgical trauma to the foveal structures.
Methods :
A case series is presented with a technique to remove submacular PFCL using a 41G gauge extendible subretinal injection needle. All surgeries were performed by one surgeon (ERG) using the same technique. The transconjunctival 27-gauge 3-port pars plana pars vitrectomy technique using the Constellation Surgical System (Alcon Laboratories, Fort Worth, TX) and a non-contact wide-angle viewing system (RESIGHT Zeiss and NGENUITY® 3D Alcon) was used in all patients. Silicone oil extraction is performed. The 41-gauge needle was carefully advanced into the subretinal space through a self-sealing retinotomy caused by the needle until the PFCL bubble was reached, by passive aspiration the PFCL was sucked out in a controlled manner until complete removal was verified, retinal reattachment was performed with liquid-air exchange and SF6 gas was used as endotamponade.
Results :
Case 1: 42-year-old male referred for submacular PFCL retention following pars plana vitrectomy for rhegmatogenous retinal detachment plus silicone oil in the right eye. BCVA (best corrected visual acuity) FC (finger count) one meter. The presence of PFCL was confirmed on optical coherence tomography showing omega sign. The PFCL was removed by the above mentioned technique. Six months after surgery his BCVA improved to 20/80.
Case 2: 64-year-old male was referred with retained subfoveal PFCL, six months after pars plana vitrectomy for macula off rhegmatogenous retinal detachment plus silicone oil. BCVA was FC at 30 centimeters. The presence of PFCL was confirmed on optical coherence tomography. Surgical removal of the subfoveal PFCL was performed using the same mentioned technique. Six months after surgery, her BCVA improved to 20/200 and OCT confirmed the elimination of the PFCL bubble.
Conclusions :
This described technique appears to be an effective surgical method to remove retained subfoveal PFCL, and also helps to limit the risk of photoreceptor damage or foveal rupture, even in a six-month case, there was improvement in visual acuity after surgical removal of the PFCL.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.