Ascaso Francisco J, Arias Luis, Caminal José M, Herrera Laura, Buey María A Del, Cristóbal José A
Department of Ophthalmology, 'Lozano Blesa' University Clinic Hospital, Zaragoza, Spain ; Aragon Health Sciences Institute, Zaragoza, Spain.
Case Rep Ophthalmol. 2012 Sep;3(3):438-42. doi: 10.1159/000346272. Epub 2012 Dec 22.
Fluid-air exchange during vitreoretinal surgery is often used as a tool for subretinal fluid endodrainage. Soft-tipped flexible extrusion cannulas are commonly used to aspirate the posterior subretinal fluid.
This is an observational two-case series describing two patients who underwent 20-G pars plana vitrectomy complicated by the accidental fall of the silicone sleeve of a soft-tipped extrusion cannula into the vitreous cavity. In the first case, the cannula had inadvertently been subjected to sterilization process.
While withdrawing the soft-tipped extrusion cannula from the eye, following internal drainage of transvitreal and subretinal fluid, the loose silicone sleeve probably got entangled at the inner lip of the sclerotomy and finally fell on the retinal surface. In both cases, the silicone sleeve was held and removed with an intraocular forceps.
This rare complication has been reported in the literature only once previously. Sterilization of disposable subretinal fluid cannulas is not advisable because of the risk of dislocation of the silicone sleeve into the eye. Besides this, it is important to check the integrity of the silicone sleeve before and after surgery.
玻璃体视网膜手术中的液气交换常被用作视网膜下液内引流的一种手段。软头柔性挤压套管通常用于抽吸视网膜后下液。
这是一个观察性的两例系列病例，描述了两名接受20G平坦部玻璃体切除术的患者，手术中软头挤压套管的硅胶套管意外掉入玻璃体腔。在第一例中，套管意外经过了消毒过程。
在经玻璃体和视网膜下液进行内引流后，将软头挤压套管从眼中拔出时，松动的硅胶套管可能在巩膜切口的内唇处缠绕，最终落在视网膜表面。在两例病例中，均用眼科镊子夹住并取出了硅胶套管。
这种罕见的并发症此前在文献中仅被报道过一次。一次性视网膜下液套管不宜进行消毒，因为存在硅胶套管脱入眼内的风险。除此之外，手术前后检查硅胶套管的完整性很重要。
