Efficacy of fluid-air exchange during pars plana vitrectomy.
OBJECTIVE
Vitreous fluid that remains trapped in the peripheral vitreous cavity after vitrectomy with fluid-air exchange can result in a smaller than desired intravitreal gas bubble size. To evaluate the effectiveness of a single fluid-air exchange in dehydrating the vitreous cavity, we measured the rate and volume of posterior vitreous fluid migration after an initial fluid-air exchange.


METHODS
Thirty-eight eyes undergoing vitrectomy for macular hole closure had measurements of posterior vitreous fluid accumulation at either 5, 10, 15, or 20 minutes after fluid-air exchange.


RESULTS
An average of 0.38 ml of fluid accumulated posteriorly within 10 minutes after the initial fluid-air exchange compared to 0.22 ml that accumulated after 5 minutes (P = 0.0003). A mean of 0.04 ml accumulated during each 5-minute interval between 10 and 20 minutes after the initial fluid-air exchange.


CONCLUSIONS
Fluid composing 10% of the vitreous volume may migrate and accumulate posteriorly within 10 minutes of an apparently complete fluid-air exchange. Fluid aspiration after a 10-minute wait after the initial fluid-air exchange helps maximize vitreous cavity dehydration and should be employed when a large gas bubble is required after vitrectomy.
Retina Institute of Maryland, Baltimore, USA.
J S
JS
Rubin
J T
JT
Thompson
R N
RN
Sjaarda
S S
SS
Pappas
B M
BM
Glaser
D000293:Adolescent; D000328:Adult; D000368:Aged; D000388:Air; D001826:Body Fluids / Q000502:physiology*; D004322:Drainage; D005260:Female; D018495:Fluid Shifts; D006801:Humans; D008297:Male; D008875:Middle Aged; D012167:Retinal Perforations / Q000601:surgery*; D013997:Time Factors; D014821:Vitrectomy; D014822:Vitreous Body / Q000502:physiology*