Moorefields Eye Hospital, Ophthalmology Department, London, England, Medical Optics, Ophthalmology Department, Dublin, Ireland, and Royal Victoria Eye and Ear Hospital, Ophthalmology Department, Dublin, Ireland.
Mater Misericordiae University Hospital.
Retina. 2023 Dec 1;43(12):2104-2108. doi: 10.1097/IAE.0000000000003422.
BACKGROUND/PURPOSE: Perfluorocarbon heavy liquid (PFCL) is used in vitreoretinal surgery to flatten the unsupported detached retina before insertion of silicone oil in cases of giant retinal tear or relaxing retinectomy. Direct exchange of PFCL for silicone oil is recommended to reduce retinal slippage when compared with fluid-air exchange, but it is commonly regarded as a difficult procedure. We describe our technique for direct PFCL-silicone oil exchange using a 20-gauge drainage cannula, reliably avoiding the complications of retinal slippage and high intraoperative intraocular pressure.
We present a consecutive case series of patients undergoing PFCL-oil exchange and explain, using Poiseuille's equation for laminar fluid flow through a cannula, the rationale for using a 20-gauge drainage cannula rather than smaller gauges to avoid high intraocular pressure.
Twenty-six patients underwent PFCL-oil exchange from February 1, 2019, to September 30, 2019. There was no intraoperative retinal slippage or pressure-related complications. Postoperatively 20 patients underwent oil removal. Six suffered retinal redetachment, and 14 remained attached. The vision postoil removal ranged from 6/6 to hand movements.
We are confident that the PFCL-oil exchange technique described here is reliable and safe. The use of a 20-gauge drainage cannula is recommended regardless of vitrectomy gauge.
背景/目的：重比重氟碳液体（PFCL）在孔源性视网膜脱离或松解性视网膜切开术中硅油填充前用于展平未支撑的脱离视网膜。与气液交换相比，直接交换 PFCL 与硅油可减少视网膜滑动，但通常被认为是一个困难的过程。我们描述了一种使用 20 号引流套管进行直接 PFCL-硅油交换的技术，可可靠地避免视网膜滑动和术中高眼压等并发症。
我们报告了一系列连续接受 PFCL-油交换的患者病例，并使用通过套管的层流泊肃叶方程解释了使用 20 号引流套管而不是更小的套管来避免高眼压的原理。
2019 年 2 月 1 日至 2019 年 9 月 30 日，26 例患者接受了 PFCL-油交换。术中无视网膜滑动或与压力相关的并发症。术后有 20 例患者取出了油。6 例发生视网膜再脱离，14 例仍保持在位。油取出后的视力范围为 6/6 至手动。
我们有信心，这里描述的 PFCL-油交换技术是可靠和安全的。无论玻璃体切除术的套管大小如何，都建议使用 20 号引流套管。
