A Novel Subfoveal Perfluorocarbon Liquid Removal Technique Combining a 25-Gauge Retrobulbar Needle With a Built-in 30-Gauge Needle

Abstract

IntroductionTo report a novel combining a 25-gauge retrobulbar needle with a built-in 30-gauge needle surgical technique for subfoveal perfluorocarbon liquid (PFCL) removal.Materials and MethodsFourteen eyes of 14 patients who underwent subfoveal PFCL removal with a 25-gauge retrobulbar needle combined with a built-in 30-gauge needle were studied. The 30-gauge needle was inserted into the 25-gauge retrobulbar needle. The bent tip of the built-in 30-gauge needle was used to create a 30-gauge retinotomy at the farthest edge of the subfoveal PFCL droplet. Then, a flute cannula was used to aspirate the PFCL through the previously created retinotomy. The best-corrected visual acuity (BCVA) was determined, previous surgical history and post-operative complications were recorded.ResultsFourteen cases were analyzed. Most eyes (92.85%) showed an improvement in BCVA after surgery. The mean change in the BCVA was −0.7 ± 0.72 logarithm of the minimum angle of resolution (logMAR) units (p = 0.006). Post-operative complications included a self-healing macular hole in one eye and vitreous hemorrhage in one eye. Post-operative optical coherence tomography confirmed removal of the subfoveal PFCL with restoration of the macular fovea.ConclusionCombining a 25-gauge retrobulbar needle with a built-in 30-gauge needle to remove subfoveal PFCL is easy to perform and carries little potential risk of subretinal impairment. This method also provides relatively good macular contour with functional improvement.

Removal of subfoveal perfluorocarbon droplet combined with internal limiting membrane peeling to flatten the macular

“…Several techniques have been proposed to remove subfoveal PFCL, including direct aspiration and displacement. Direct aspiration is mainly performed at the edge or at the top of the PFCL bubble using various cannulas, ranging from 25 to 50 gauge [5][6][7] . PFCL displacement may be performed inducing a temporary retinal detachment or with a small retinotomy, followed by direct aspiration, intraoperative body position change, or injecting/ flushing saline solution gently [5,[8][9] .…”