title: Iatrogenic retinal breaks caused by infusion fluid during pars plana vitrectomy.
abstract: OBJECTIVE
  To describe a series of cases of iatrogenic retinal breaks (IRBs) caused by the infusion fluid flow of a 25-gauge pars plana vitrectomy (PPV) system.
  
  
  METHODS
  Retrospective case series.
  
  
  METHODS
  During 25-gauge PPV, 4 cases had IRBs caused by infusion fluid flow. The IRBs rapidly progressed to localized retinal detachment.
  
  
  RESULTS
  The first 3 cases had IRBs on the nasal quadrant midperiphery of the retina. The IRBs were treated with laser retinopexy and tamponade during surgery. Case 4 had a macular hole and macular detachment during scleral indentation. The IRBs seemed to be caused by intraocular pressure (IOP) control mechanisms of the vitrectomy device.
  
  
  CONCLUSIONS
  To prevent IRBs caused by infusion fluid flow, we recommend using an IOP control limit of 4 mL/min for 25-gauge vitrectomy, with valved cannulas. In addition, the surgeon must be cautious during scleral indentation and air-fluid exchange not to cause a rebound hypotonia.
authors: Ophthalmology Department, Akdeniz University School of Medicine, Antalya, Turkey. Electronic address: gozdrburakbilgin@gmail.com.
authors: Ahmet Burak
authors: AB
authors: Bilgin
authors: Ophthalmology Department, Akdeniz University School of Medicine, Antalya, Turkey.
authors: Elif Betül
authors: EB
authors: Türkoğlu
authors: Ophthalmology Department, Akdeniz University School of Medicine, Antalya, Turkey.
authors: Hatice Deniz
authors: HD
authors: İlhan
authors: Ophthalmology Department, Akdeniz University School of Medicine, Antalya, Turkey.
authors: Mustafa
authors: M
authors: Ünal
authors: Ophthalmology Department, Akdeniz University School of Medicine, Antalya, Turkey.
authors: K Cemil
authors: KC
authors: Apaydın
mesh_terms: D000293:Adolescent; D000368:Aged; D000369:Aged, 80 and over; D058450:Endotamponade; D005260:Female; D005466:Fluorocarbons / Q000008:administration & dosage; D006801:Humans; D007049:Iatrogenic Disease; D017075:Laser Coagulation; D053685:Laser Therapy; D008297:Male; D019999:Pharmaceutical Solutions / Q000009:adverse effects*; D012160:Retina / Q000293:injuries*; D012163:Retinal Detachment / Q000209:etiology* / Q000601:surgery; D012167:Retinal Perforations / Q000209:etiology* / Q000601:surgery; D012189:Retrospective Studies; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy / Q000295:instrumentation*
chemical_list: D005466:Fluorocarbons; D019999:Pharmaceutical Solutions; C042852:perflutren