Vitreoperfusion. A new approach to ocular ischemia.

No satisfactory treatment is available to supply the metabolic needs of the retina in vascular occlusion. Consequently, necrosis occurs. We devised vitreoperfusion, a technique of perfusing the vitreous cavity after vitrectomy-lensectomy with selected fluids containing glucose and oxygen. We tested whether vitreoperfusion could protect the retina from severe combined retinal and choroidal ischemia. An intraocular pressure of 170 mm Hg was induced in each eye of nine cats for up to four hours, and simultaneously one eye of each cat underwent vitreoperfusion. After one week, histopathologic examination revealed retinal atrophy and dissolution in untreated eyes but not in eyes treated with vitreoperfusion. To our knowledge, such severe ischemia has never been treated successfully before. Vitreoperfusion is a potential treatment modality in various forms of ocular ischemia. Additional studies are warranted to refine the technique and determine any clinical applicability.