gms | German Medical Science

Introduction: Severe proliferative vitreoretinopathy (PVR) is a common occurrence in open globe trauma. The removal of subretinal PVR during vitrectmy may be difficult due to the necessity of retinotomies, poor visualization and retinal mobility. Heavy liquids have oftem been used to maintain the retina attached as epiretinal PVR is removed. We would like to describe our technique for the use of subretinal perfluorocarbon liquids to aid in the removal of severe subretinal PVR.

Technique: In cases with severe subretinal PVR in which it is mandatory to remove it to achieve attachment of the retina a full vitrectomy is performed including removal of the posterior hyaloid and vitreous base dissection. Epiretinal PVR is fully dissected. At this time the necessity for retinotomies and subretinal PVR removal is noted due to the failure to reattach the retina. A peripheral retinotomy, at least 180° is performed on the side where PVR is to be removed. Subretinal perfluorooctane is injected folding the retina over itself as the heavy liquid bubble fills the posterior segment allowing full visibility of the subretinal space and outer retina surface. PVR may be dissected as needed. The perfluorocarbon liquid is completely removed and reinjected in the vitreous cavity to apply the retina. Laser may be applied as the necessary tamponade. (A video of the technique will be shown)

Results: This technique has allowed us to remove subretinal PVR that otherwise would have been difficult.

Conclusion: We believe that the use of subretinal heavy perfliorocarbon liquids may aid in the removal of subretinal PVR thus improving chances of retinal reattachment.