Guo Jingli, Gu Victoria Y, Zhou Yuhan, Zhao Peiquan, Zhao Dongsheng
Department of Ophthalmology, Xin Hua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Int J Retina Vitreous. 2024 Oct 11;10(1):76. doi: 10.1186/s40942-024-00591-z.
To present a novel intraoperative application technique of basic salt solution (BSS) perfusate to address residual epiretinal perfluorocarbon liquid (PFCL) droplets.
Following standard liquid-gas exchange and aspiration of visible PFCL using a flute needle, the adjuvant drip-irrigative method is employed. A 2mL needle containing BSS is introduced and maneuvered circumferentially around the posterior pole while injecting BSS intermittently to obviate droplet presence. Subsequently, droplets lying flat to the surface drain via the flute needle, and the process if repeated until no droplets are visible.
Among 112 consecutive patients diagnosed with rhegmatogenous retinal detachment (RDD) with at least 3 months follow-up, 109 patients (109 eyes, [97%]) experienced no PFCL-related complications follow pars plana vitrectomy. Among three patients with PFCL-related complications, two (2 eyes) presented with residual droplets on the retinal surface during silicone oil retrieval, and one (1 eyes) had PFCL migration to the anterior chamber. No patients experienced sub-retinal/ sub-foveal PFCL or iatrogenic injury.
This adjuvant drip-irrigative technique offers enhanced droplet visibility, reduced risk of iatrogenic retinal damage, and ease of application. Findings reported suggest the potential of this approach as a standard practice when using PFCL to mitigate complications.
介绍一种新型的术中应用基础盐溶液（BSS）灌注液的技术，以处理视网膜前全氟碳液体（PFCL）残留液滴。
在进行标准的液-气交换并使用笛形针抽吸可见的PFCL之后，采用辅助滴注冲洗法。将一支装有BSS的2mL针引入并在后极周围圆周移动，同时间歇性地注入BSS以消除液滴的存在。随后，贴于表面的液滴通过笛形针排出，重复该过程直至看不到液滴。
在112例连续诊断为孔源性视网膜脱离（RDD）且至少随访3个月的患者中，109例患者（109只眼，[97%]）在玻璃体切除术后未出现与PFCL相关的并发症。在3例与PFCL相关并发症的患者中，2例（2只眼）在硅油取出时视网膜表面有残留液滴，1例（1只眼）出现PFCL向前房迁移。没有患者发生视网膜下/黄斑下PFCL或医源性损伤。
这种辅助滴注冲洗技术提高了液滴的可见性，降低了医源性视网膜损伤的风险，且易于应用。报告的研究结果表明，在使用PFCL减轻并发症时，这种方法有可能成为一种标准操作。
