Sub-perfluoro-n-octane injection of ocular viscoelastic device assisted inverted internal limiting membrane flap for macular hole retinal detachment surgery: a novel technique

Abstract

Background: To evaluate the feasibility of a surgical technique using a sub-perfluoro-n-octane (PFO) injection of ocular viscoelastic device (OVD) to stabilize inverted internal limiting membrane (ILM) flap for the treatment of macular hole retinal detachment (MHRD). Methods: This study was a retrospective, consecutive, interventional case series. Patients who underwent MHRD surgery with sub-PFO injection of OVD to stabilize inverted ILM flap onto the macular hole (MH) were reviewed. The color fundus and optical coherence tomography (OCT) images were collected and evaluated. The bestcorrected visual acuity (BCVA) before and after surgery were compared as the functional outcome. Results: The study included 8 eyes of 8 consecutive patients (mean age: 61.8 ± 7.1 years; mean follow-up period: 9.0 ± 2.5 months). All eyes (100%) achieved successful MH closure; 7 eyes (87.5%) demonstrated complete retinal reattachment, and 1 eye (12.5%) had minimal residual subretinal fluid parafoveally. Of the 8 patients, 7 patients (87.5%) had achieved improvement in BCVA after the primary surgery, whereas 1 eye remained stable. The average BCVA before and after the surgery at the last visit improved from 20/843 (1.63 ± 0.48 logMAR) to 20/200 (1.00 ± 0.39 logMAR) (P = 0.016). Anatomically, near-normal foveal contour was noted in five (62.5%) eyes at the final follow-up. Conclusions: The use of sub-PFO injection of OVD in MHRD surgery could stabilize inverted ILM flaps, achieve good anatomical results and improve postoperative BCVA.

Scleral Buckling with Viscoelastics or Gas Injection for Bulging Retinal Detachments: A Retrospective Cohort Study

“…In addition, a recent comparative multicenter study demonstrated that limited vitrectomy is time-efficient and effective in removing epiretinal membrane without additional complications compared to complete vitrectomy [25]. Another study reported good outcomes of sub-perfluoro-n-octane injection as a viscoelastic agent in patients with macular hole retinal detachment [26]. e rate of retinal reattachment was numerically higher, but the difference was not significant, probably because of the small number of patients.…”

Peeling and Internal Limiting Membrane Reposition (Pair) for Myopic Foveoschisis

“…Then, perfluorocarbon liquid (PFCL; Alcon) was injected from the site of the ILM hinge to flatten the peeled ILM, and the ILM was returned to its original position by using the DDMS. To secure the repositioned ILM, an ophthalmic viscoelastic device (OVD; Viscoat; Alcon) was placed along the edge of the peeled ILM by using the sub-PFCL ophthalmic viscoelastic device injection (SPOT) technique 7,8 (See Video, Supplemental Digital Content 1, http://links.lww. com/IAE/B726, in which the PAIR and SPOT techniques are demonstrated).…”

Surgical Management of Recurrent and Persistent Macular Holes: A Practical Approach

“…Similar results with high closure rates and improvements in vision have been reported in other similarly sized series with large MHs [ 58 – 60 ]. Maintaining the tissue within the hole may be difficult during air-fluid exchange, but use of perfluorocarbon or viscoelastic, as previously mentioned, can help tamponade the flap in place during this step of the surgery [ 61 , 62 ]. The pedunculated flap is where an ILM flap larger than the radius of the hole to the edge of the previous ILM peel is fashioned with the hinge at the edge of the previous ILM peel.…”