title: Retinal damage caused by air-fluid exchange during pars plana vitrectomy.
abstract: 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.
authors.affiliation: Pacific Vision Foundation, California Pacific Medical Center, San Francisco, California, USA.
authors.forename: Sam S
authors.initials: SS
authors.lastname: Yang
authors.forename: H Richard
authors.initials: HR
authors.lastname: McDonald
authors.forename: A I
authors.initials: AI
authors.lastname: Everett
authors.forename: Robert N
authors.initials: RN
authors.lastname: Johnson
authors.forename: J Michael
authors.initials: JM
authors.lastname: Jumper
authors.forename: Arthur D
authors.initials: AD
authors.lastname: Fu
mesh_terms: 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*