Bilgin Ahmet Burak, Türkoğlu Elif Betül, İlhan Hatice Deniz, Ünal Mustafa, Apaydın K Cemil
Ophthalmology Department, Akdeniz University School of Medicine, Antalya, Turkey.
Ophthalmology Department, Akdeniz University School of Medicine, Antalya, Turkey.
Can J Ophthalmol. 2015 Feb;50(1):77-9. doi: 10.1016/j.jcjo.2014.08.016.
To describe a series of cases of iatrogenic retinal breaks (IRBs) caused by the infusion fluid flow of a 25-gauge pars plana vitrectomy (PPV) system.
Retrospective case series.
During 25-gauge PPV, 4 cases had IRBs caused by infusion fluid flow. The IRBs rapidly progressed to localized retinal detachment.
The first 3 cases had IRBs on the nasal quadrant midperiphery of the retina. The IRBs were treated with laser retinopexy and tamponade during surgery. Case 4 had a macular hole and macular detachment during scleral indentation. The IRBs seemed to be caused by intraocular pressure (IOP) control mechanisms of the vitrectomy device.
To prevent IRBs caused by infusion fluid flow, we recommend using an IOP control limit of 4 mL/min for 25-gauge vitrectomy, with valved cannulas. In addition, the surgeon must be cautious during scleral indentation and air-fluid exchange not to cause a rebound hypotonia.
描述一系列由25G玻璃体切割系统灌注液流动导致的医源性视网膜裂孔（IRB）病例。
回顾性病例系列研究。
在25G玻璃体切割术中，4例患者因灌注液流动导致IRB。这些IRB迅速发展为局限性视网膜脱离。
前3例患者的IRB位于视网膜鼻侧象限中周部。术中采用激光视网膜光凝和眼内填充治疗这些IRB。病例4在巩膜压陷时出现黄斑裂孔和黄斑脱离。这些IRB似乎是由玻璃体切割设备的眼压（IOP）控制机制引起的。
为预防灌注液流动导致的IRB，我们建议25G玻璃体切割术使用带阀门的套管时，将IOP控制限度设定为4 mL/分钟。此外，在巩膜压陷和气液交换过程中，术者必须小心谨慎，以免引起眼压反跳性降低。
