Department of Ophthalmology, LKS Faculty of Medicine, University of Hong Kong, Hong Kong, Hong Kong.
Sunderland Eye Infirmary, Sunderland, UK.
Acta Ophthalmol. 2021 Dec;99(8):e1517-e1523. doi: 10.1111/aos.14832. Epub 2021 Mar 5.
To investigate the physics associated with the retention and removal of subretinal perfluorocarbon liquid (PFCL), as inspired by a series of anecdotal cases of spontaneous 'disappearance' of subretinal PFCL.
The profiles of subretinal PFCL in situ from published OCT images were studied and compared with that of PFCL droplets resting on a hydrophilic surface in vitro. A mathematical model based on Sampson's and Poiseuille's formula was developed to explain how evacuation of subretinal PFCL without aspiration could occur.
The mathematical model suggested that in vivo subretinal PFCL can completely evacuate in less than a second via a 41-guage retinal hole. Perfluorocarbon liquid (PFCL) droplets in situ subretinally substantially varied in their aspect ratios (from 0.28 to 2.71) and their contact angles with the retinal pigment epithelium (from 98° to 155°). Conversely, PFCL in vitro had aspect ratios and contact angles close to 1 and 150° respectively.
This study showed evidence that stretching of the retina to accommodate subretinal PFCL occurs, which might be responsible for the varied profile of the droplets and resultant forces that can cause retinal holes, and spontaneous evacuation of large PFCL droplets. By filling the vitreous cavity with PFCL, a small retinotomy alone might allow spontaneous evacuation without the need for aspiration.
受一系列视网膜下全氟碳液体(PFCL)自发“消失”的偶发案例启发,研究与视网膜下 PFCL 保留和清除相关的物理学现象。
研究了已发表的 OCT 图像中视网膜下 PFCL 的原位分布,并与在亲水表面上的 PFCL 液滴的分布进行了比较。基于 Sampson 和 Poiseuille 公式建立了一个数学模型,以解释在没有抽吸的情况下如何排出视网膜下的 PFCL。
数学模型表明,通过一个 41 号视网膜穿刺孔,视网膜下的 PFCL 可以在不到一秒的时间内完全排空。原位的视网膜下 PFCL 液滴在其纵横比(从 0.28 到 2.71)和与视网膜色素上皮的接触角(从 98°到 155°)方面有很大的差异。相反,体外的 PFCL 的纵横比和接触角分别接近 1 和 150°。
本研究表明,视网膜的拉伸以适应视网膜下的 PFCL 是发生的,这可能是导致液滴的不同形态和由此产生的力的原因,这些力可能导致视网膜穿孔和大的 PFCL 液滴的自发排空。通过向玻璃体腔中填充 PFCL,单独一个小的视网膜切开术就可能允许在不需要抽吸的情况下自发排空。