title: Fluid air exchange in vitreo retinal surgery.
abstract: This study evaluates the efficiency of fluid-air exchange on the reattachment of the retina and clarifies the possibility that a posterior retinotomy is a cause for intra- and postoperative complications. A consecutive series of 211 eyes with retinal detachments due to P.V.R. (47%), diabetic traction, perforating trauma, macular hole or giant tears is presented. All eyes underwent pars plana vitrectomy, fluid-air exchange, internal drainage of subretinal fluid, laser endophotocoagulation and scleral buckling of the tears; 56% of the eyes were phakic and 55% underwent a posterior retinotomy, 54% underwent tamponade with C3F8 and 46% with silicone oil. Intraoperatively the retina was completely flattened in 91% cases. The causes of incomplete reattachment were residual membranes (6.6%), poor visualization (1.4%) and suprachoroidal hemorrhage (1%). These complications were isolated as being the cause of the bad final results (p < 0.001). Postoperatively, the retina remained attached in 66% of cases after the first procedure and with further surgery in 81% (mean follow up 16 months). Best corrected visual acuity was improved in 73% of eyes, unchanged in 17%, and worse in 10%. Complications were retraction of the retinotomy site in 3 cases and peripheral choroidal hemorrhage in 4 cases. We concluded that fluid air exchange with internal subretinal fluid drainage was an efficient and safe technique even if a posterior retinotomy was necessary.
authors.affiliation: Service d'Ophtalmologie C.H.U. de Nancy, Hôpital Central C.O 34, France.
authors.forename: J P
authors.initials: JP
authors.lastname: Berrod
authors.forename: P
authors.initials: P
authors.lastname: Rozot
authors.forename: A
authors.initials: A
authors.lastname: Raspiller
authors.forename: D
authors.initials: D
authors.lastname: Thiery
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000388:Air; D002648:Child; D005466:Fluorocarbons; D006801:Humans; D007431:Intraoperative Complications; D007552:Isotonic Solutions; D017075:Laser Coagulation; D008875:Middle Aged; D011183:Postoperative Complications; D012163:Retinal Detachment / Q000209:etiology / Q000601:surgery*; D012189:Retrospective Studies; D012591:Scleral Buckling; D012827:Silicone Oils; D014792:Visual Acuity; D014821:Vitrectomy / Q000379:methods*
chemical_list: D005466:Fluorocarbons; D007552:Isotonic Solutions; D012827:Silicone Oils; C042852:perflutren