Duration of intraocular gases following vitreoretinal surgery

Kontos, Andreas; Tee, James; Stuart, Alastair; Shalchi, Zaid; Williamson, Tom H.

doi:10.1007/s00417-016-3438-3

Cited by 43 publications

(35 citation statements)

References 19 publications

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“…Single- or multiple-use systems are available, in low- or high-pressure containers with reducers. In practice, the final concentration used during vitrectomy is at the surgeon's discretion, ranging from 18 to 30%; for example, in the UK a 20% compound is most commonly applied [ 4 ]. A 100% concentration of SF 6 is used for retinal detachment pneumatic retinopexy [ 5 ], displacement of submacular hemorrhages secondary to choroidal neovascular membrane, and retinal arterial macroaneurysm [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

Case Series of Inappropriate Concentration of Intraocular Sulfur Hexafluoride

Kanclerz¹,

Grzybowski

2018

Case Rep Ophthalmol

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Due to high complexity, vitreoretinal surgery presents a higher number of patient safety incidents compared with other ophthalmic procedures. Intraocular gases are one of the most useful adjuncts to vitrectomy and surprisingly, surgeons commonly admit to having occasional problems with incorrect gas concentration. The aim of this study is to present a consecutive case series of patients with improper concentration of sulfur hexafluoride (SF₆) applied during vitrectomy. Three patients underwent 27-gauge vitrectomy and at the end of surgery inappropriate dilution of 100% SF₆ was administered. It was attributed to a calculation error, change in the gas supplier, or increased partial pressure of SF₆ before dilution. Postoperatively, due to IOP increase, two eyes required intravitreal gas-air exchange. Subsequently, cataract surgery was performed in one eye with concomitant vitrectomy and silicone oil tamponade due to retinal detachment. To prevent such complications, we suggest using intraocular gases with great care, training of ophthalmic personnel, and prompting manufacturers to provide SF₆ in a prepared concentration of 20%.

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Section: Discussionmentioning

confidence: 99%

Case Series of Inappropriate Concentration of Intraocular Sulfur Hexafluoride

Kanclerz¹,

Grzybowski

2018

Case Rep Ophthalmol

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“…Postoperative IOP changes. IOP at one, three, and 10 days and 1 and 2 months postoperatively was 16.37 ± 5.61 (minimum-maximum: 7-31), 16.62 ± 5.52 (9-33), 16.37 ± 4.63 (10-28), 15.38 ± 3.10 (10-27), and 15.04 ± 3.56 (11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24) (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19) in the 20% group. The effect of gas concentration on postoperative IOP was not statistically significant (p = 0.559, repeated-measures analysis of variance test).…”

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confidence: 96%

“…Subsequently, the partial pressures of nitrogen, oxygen, and carbon dioxide with the retinal blood gas partial pressures are equalized and absorbed slowly 9,10 . For C 3 F 8 , 10% to 17% concentrations have been suggested as possible concentrations to prevent excessive expansion and the elevation of intraocular pressure (IOP) [11][12][13] . Previously, many studies were conducted on gas behavior and longevity in the eye, but most experiments were completed using animal models [14][15][16] or predicted through experimental models 17,18 , and there is a shortage of reports that objectively analyzed changes in intravitreal gas in the human eye 19,20 .…”

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confidence: 99%

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Objective analysis of perfluoropropane tamponade area after pars plana vitrectomy using ultra-widefield fundus stereographic projection images

Choi

Hong

Yun

et al. 2020

Sci Rep

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To objectively analyze the gas tamponade area in patients with different concentrations of perfluoropropane (C3F8) after pars plana vitrectomy (PPV), retrospective analysis was performed in patients diagnosed with retinal detachment or macular hole and underwent PPV with C3F8 tamponade of two concentrations (14% and 20%). The ultra-widefield fundus (UWF) images at one and 10 days and four weeks postoperatively were corrected using stereographic projection to adjust peripheral distortion. The gas–fluid interface curvatures were delineated using UWF stereographic projection images, and the gas–fluid area ratio and estimated gas area were calculated at each concentration. Among 65 eyes, 30 were in the 14% group and 35 were in the 20% group. The gas–fluid area ratio was 0.71 in the 14% group and 0.83 in the 20% group at 10 days (p = 0.046) and 0.27 and 0.45, respectively, at four weeks postoperatively (p < 0.001). The estimated gas area was 52.56 and 60.82 mm2 at 10 days (p = 0.025) and 19.83 and 33.86 mm2 at four weeks (p < 0.001). The gas tamponade areas were objectively shown to be greater under the 20% concentration than the 14% concentration of C3F8 at 10 days and 4 weeks postoperatively using UWF stereographic projection images.

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“…It is known that the maximal expansion of this gas is produced after 24 to 48 hours, its expansivity being 2 if the gas is pure. 5 However, the safety of 0.25 mL of SF 6 even at 100% concentration has been described in one case. 6 The anterior chamber was not shallow in our patient, so we think that the volume of 0.3 mL was adequate.…”

mentioning

confidence: 98%