gms | German Medical Science

Purpose: To describe the use of subretinal trypan blue to identify retinal breaks during re-vitrectomy for recurrent retinal detachment (RD) in post-vitrectomy eyes of rhegmatogenous retinal detachment.

Methods: Three patients with RD in whom no retinal break could be identified by internal search with scleral indentation. Trypan blue 0.15% was injected transretinal into the subretinal space using a 41-gauge cannula. Perfluorocarbon heavy liquid was then injected into the vitreous cavity and fluid air exchange such that trypan blue was vented out of the break. The plume of trypan blue was used to identify retinal breaks. Subretinal fluid was then drained through the break and surgery was completed using standard techniques.

Results: This technique successfully identified a retinal break in all patients. In all cases were found to have a small crevice-like break beside the pigment scar of a large number of original laser spots. After absorption of the gas tamponade all retinas remained attached. Good vision in both cases was achieved.

Conclusion: The use of the intraoperative diagnostic method allows the surgeon to detect retinal breaks, which reduces the volume of surgical intervention and increases its efficiency.