Retinal damage caused by air-fluid exchange during pars plana vitrectomy.
OBJECTIVE
To report two cases of retinal damage associated with air infusion during pars plana vitrectomy.


METHODS
Observational case report.


METHODS
The authors reviewed the course of two patients who had retinal damage during par plana vitrectomy and air-fluid exchange for the treatment of macular hole and optic pit-related macular detachment, respectively. The intraoperative observations, postoperative course, and outcomes were reported.


RESULTS
As a result of high air infusion flow during air-fluid exchange, retinal damage was created in the area contralateral to the infusion port. In Case 1, an oval area of whitening was noted on the first postoperative day. This area subsequently developed into a large retinal break associated with retinal detachment. In the second case, retinal whitening was noted intraoperatively. This region of pallor resolved quickly during the early postoperative period but resulted in a corresponding inferotemporal visual field defect.


CONCLUSIONS
High infusion flow during air-fluid exchange in eyes undergoing vitrectomy surgery may result in significant retinal damage. This pressure-induced trauma initially causes retinal whitening that may be seen intraoperatively or during the early postoperative period. The region of damaged retina may develop a retinal break and detachment or a corresponding visual field defect.
Yang
Sam S
SS
Pacific Vision Foundation, California Pacific Medical Center, San Francisco, California, USA.
McDonald
H Richard
HR
Everett
A I
AI
Johnson
Robert N
RN
Jumper
J Michael
JM
Fu
Arthur D
AD
D000328:Adult; D000388:Air; D005131:Eye Injuries / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D007431:Intraoperative Complications; D008297:Male; D008875:Middle Aged; D012160:Retina / Q000293:injuries* / Q000503:physiopathology; D012164:Retinal Diseases / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D014786:Vision Disorders / Q000209:etiology; D014794:Visual Fields; D014821:Vitrectomy / Q000009:adverse effects*