<p>Displacement of Retained Subretinal Perfluorocarbon Liquid Through Therapeutic Retinal Detachment Induced by Balanced Salt Solution Injection</p>

Abstract

Purpose: To report a case of displacement of retained subretinal perfluorocarbon liquid (PFCL) through therapeutic retinal detachment (RD) induced by balanced salt solution (BSS) injection. Methods: This is a surgical case report. We present a case of a 61-year-old woman who presented with subretinal PFCL at the papillo-macular bundle with best-corrected visual acuity (BCVA) of 20/200 at four weeks following RD surgery in her right eye. She underwent a three-port pars plana vitrectomy with therapeutic RD of a portion of the posterior pole and inferior periphery induced by BSS injection, followed by complete air-fluid exchange, and kept an upright position for three days to force the displacement of the PFCL bubble towards the inferior retinal periphery. BCVA assessment, dilated fundus examination (DFE), and optical coherence tomography (OCT) were performed before and after the surgery. Results: Two weeks after the procedure, BCVA improved to 20/40, the subretinal PFCL was not visible on DFE, and a control OCT confirmed displacement of the PFCL bubble with atrophy at the papillo-macular bundle. There were no complications. Conclusion: Displacement of retained subretinal PFCL through therapeutic RD induced by BSS injection seems to be an effective technique with fewer potential complications in comparison to the more traditional approach of removal by direct aspiration.

Glittering subfoveal perfluorocarbon liquid

“…Retained subretinal PFCL is a relatively rare but dreadful complication seen in almost 11% of cases of RRD requiring PFCL intraoperatively, 1 the two most common risk factors are being large peripheral retinotomies extending more than 120° and inadequate saline rinse at the conclusion of fluid-air exchange. 2 One possible cause of retained subfoveal PFCL in our case could be secondary to the persistent subretinal band, which could have aided entry of an undetected PFCL droplet into the subretinal space and migration into the macula, by acting as a conduit or 'tenting up' the retina in the macula. Retained subfoveal PFCL can lead to acute vision loss secondary to an inflammatory reaction involving macrophages with intracellular vacuoles containing PFCL and mechanical compression of the retina, mandating immediate surgical intervention.…”

Subretinal silicone oil: OCT imaging findings and surgical management of a rare and unusual iatrogenic complication of retinal detachment surgery

“…Various liquids and tamponade agents are used during retinal detachment surgery, and surgeons must take great care to avoid them being retained in the vitreous cavity or migrating subretinally. There are a number of reports in the literature demonstrating retained heavy liquid (PFCL) under the retina and techniques described to remove it 1–6. However, there is a paucity in the literature of similar problems with silicone oil.…”

Vitreous Substitutes from Bench to the Operating Room in a Translational Approach: Review and Future Endeavors in Vitreoretinal Surgery

“…More in detail, a tamponading agent with high interfacial tension, such as gas or perfluorocarbon liquids (PFCL), will not readily sneak into the subretinal space through retinal tears because to do so, it would need to increase its surface area. This process requires the application of a high enough energy to supersede the Van der Waals forces, and therefore it can happen only when, for example, the gravity force applies energy on a PFCL bubble sitting over a stiffened, teared retina, possibly leading to the feared complication of retained subfoveal PFCL [ 54 , 55 , 56 ].…”