Perfluorocarbon-perfused vitrectomy: a new method for vitrectomy—a safety and feasibility study

Abstract

PCPV in humans is a safe and feasible technique. Probably in selected cases the use of PCL offers several advantages over BSS, because of their properties (gravitational forces, immiscibility with bodily fluids, and ability to transport oxygen). Prospective and comparative studies are necessary to establish formal indications and possible contraindications.

Diabetic vitrectomy: risks, prognosis, future trends

“…Some investigators have reported the application of intravitreal heparin infusion as an aid to removing clotting preretinal hemorrhage intraoperatively [24], as well as the use of low molecular weight heparin (enoxaprin) in the infusion to help decrease the formation of postvitrectomy fibrin [27]. Others have introduced the idea of perfluorocarbon-perfused PPV, which may offer advantages over Balanced Salt Solution infusion in terms of immiscibility with bodily fluids, ability to transport oxygen and gravitational forces [28]. These techniques may offer protective effects against ischemia during and after surgical procedures, which remains the scourge of both surgeon and patient in the early postoperative period.…”

Perfluorocarbon-Perfused Vitrectomy Using a Transconjunctival 25-Gauge System

“…On the other hand, the use of PCL provides certain advantages that have been proven in previous studies 3,4 and that could compensate for the difficulties encountered when performing 25-gauge vitrectomy in complicated cases. These advantages are derived from the specific physical/mechanical properties of PCL, which include immiscibility with bodily fluids and a high specific gravity.…”

Perfluorocarbon-perfused 23 gauge three-dimensional vitrectomy for complicated diabetic tractional retinal detachment

“…Since its introduction by Chang et al in 1987, the use of perfluorocarbon liquids (PCLs) as surgical adjuvants has spread throughout the world and currently forms part of every retina practice 11–14. PCLs are fluorinated carbon molecules, with a high affinity for oxygen.…”

“…In a previous report, we described a surgical technique in which we used PCL as an infusion substance instead of regular saline 14. The advantages identified in this procedure were: its high oxygen-carrying capacity, which may be useful during surgery on an ischemic retina; oxygen affinity, which may facilitate elevation of intraocular pressure, allowing a hemorrhage-free surgery; immiscibility of PCL with blood and debris, which may facilitate surgery and improve surgical efficiency; and the high density of PCL, which may help to reattach and stabilize the retina during vitrectomy and membrane peeling 14,15.…”

“…The advantages identified in this procedure were: its high oxygen-carrying capacity, which may be useful during surgery on an ischemic retina; oxygen affinity, which may facilitate elevation of intraocular pressure, allowing a hemorrhage-free surgery; immiscibility of PCL with blood and debris, which may facilitate surgery and improve surgical efficiency; and the high density of PCL, which may help to reattach and stabilize the retina during vitrectomy and membrane peeling 14,15. However, regardless of the aforementioned advantages, the original technique was described using vitrectomy probes of existing caliber (20 gauge) and available vitrectomy machines.…”