title: Direct transretinal removal of subfoveal perfluorocarbon liquid: the role and timing of internal limiting membrane peeling.
abstract: OBJECTIVE
  To describe a case series including 4 patients undergoing direct transretinal aspiration of subfoveal perfluorocarbon liquid (PFCL) and internal limiting membrane (ILM) peeling after macula-off retinal detachment surgery.
  
  
  METHODS
  Four patients who had undergone vitreoretinal surgery due to primary rhegmatogenous retinal detachment were further treated because of retained subfoveal PFCL. Direct transretinal aspiration of PFCL through a self-sealing foveal retinotomy was performed in all cases using a 41-G needle placed on the top of the bubble. The ILM was peeled off prior to and after PFCL removal in 2 cases, respectively. Optical coherence tomography (OCT) scans were obtained preoperatively and postoperatively to assess the status of the macula.
  
  
  RESULTS
  Subfoveal PFCL was successfully removed in all cases. Two patients had silicone oil tamponade at the time of the second surgery, which was temporarily removed in both cases and then reapplied in one. Best-corrected visual acuity improved in all cases. No postoperative macular hole was observed by OCT.
  
  
  CONCLUSIONS
  Direct transretinal aspiration of subfoveal PFCL with a 41-G cannula combined with conventional ILM peeling is a safe and effective technique to avoid long-term damage to the retinal layers with good functional outcomes. Performing the ILM peeling immediately before or after the PFCL aspiration does not seem to influence anatomic results.
authors.affiliation: Azienda Ospedaliero-Universitaria "Maggiore della Carità", SCDO Oculistica, Novara - Italy.|Health Sciences Department, Università del Piemonte Orientale - Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: De Cillà
authors.affiliation: Azienda Ospedaliero-Universitaria "Maggiore della Carità", SCDO Oculistica, Novara - Italy.
authors.forename: Micol
authors.initials: M
authors.lastname: Alkabes
authors.affiliation: Ospedale Fatebenefratelli e Oftalmico, Milan - Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Radice
authors.affiliation: Ospedale Fatebenefratelli e Oftalmico, Milan - Italy.
authors.forename: Elisa
authors.initials: E
authors.lastname: Carini
authors.affiliation: Institute of Ocular Microsurgery (IMO), Barcelona - Spain.
authors.forename: Carlos
authors.initials: C
authors.lastname: Mateo
mesh_terms: D001485:Basement Membrane / Q000601:surgery; D019773:Epiretinal Membrane / Q000601:surgery; D005466:Fluorocarbons / Q000008:administration & dosage*; D006801:Humans; D019152:Paracentesis / Q000379:methods*; D011183:Postoperative Complications / Q000601:surgery*; D012163:Retinal Detachment / Q000601:surgery*; D012167:Retinal Perforations / Q000517:prevention & control; D013459:Sulfur Hexafluoride / Q000008:administration & dosage; D041623:Tomography, Optical Coherence; D014792:Visual Acuity; D014821:Vitrectomy / Q000009:adverse effects* / Q000379:methods
chemical_list: D005466:Fluorocarbons; D013459:Sulfur Hexafluoride