Shigeyasu Chika, Imamura Yutaka, Ishida Susumu, Tsubota Kazuo, Inoue Makoto
From the *Department of Ophthalmology, Keio University School of Medicine; and †Department of Ophthalmology, Kyorin Eye Center, Kyorin University School of Medicine, Tokyo, Japan.
Retin Cases Brief Rep. 2009 Summer;3(3):305-7. doi: 10.1097/ICB.0b013e31818ad3a8.
To report a new method to stabilize and unfold a retinal fragment during vitrectomy for severe globe rupture.
Case report and intraoperative observations.
A 43-year-old man with a severe globe rupture and extensive retinal herniation through the rupture.
Pars plana vitrectomy was performed 10 days after the closure of the wound. When retinotomy was performed at the site of the retinal incarceration, a piece of rolled-up retina was seen floating around the optic disc. The retinal movement was stopped by an injection of viscoelastic material that filled the vitreous cavity, and then perfluorocarbon liquid was injected to tamponade the retina to the retinal pigmented epithelium. Then, the residual retinal fragment was unfolded and pressed against the retinal pigmented epithelium using a bimanual technique. After 3 years, the patient's vision recovered to hand motion under silicone oil tamponade.
The simultaneous use of intravitreal viscoelastics and perfluorocarbon liquid can be used to stabilize and manipulate floating retinal fragments during vitrectomy after severe rupture of the globe.
