The Effect of Temperature Changes in Vitreoretinal Surgery.

ABSTRACT

PURPOSE: Recent studies on temperature control in biology and medicine have found the temperature as a new instrument in healthcare. In this manuscript, we reviewed the effects of temperature and its potential role in pars plana vitrectomy. We also examined the relationship between intraocular pressure, viscosity, and temperature in order to determine the best balance to manipulate the tamponades during the surgery. METHODS: A literature review was performed to identify potentially relevant studies on intraocular temperature. Physics equations were applied to explain the described effects of temperature changes on the behavior of the endotamponades commonly used during vitreoretinal surgery. We also generated an operating diagram on the pressure-temperature plane for the values of both vapor-liquid equilibrium and intraocular pressure. RESULTS: The rapid circulation of fluid in the vitreous cavity reduces the heat produced by the retinal and choroidal surface, bringing the temperature toward room temperature (22°C, deep hypothermia). Temperature increases with endolaser treatment, air infusion, and the presence of silicone oil. The variations in temperature during vitreoretinal surgery are clinically significant, as the rheology of tamponades can be better manipulated by modulating intraocular pressure and temperature. CONCLUSIONS: During vitreoretinal surgery, the intraocular temperature showed rapid and significant fluctuations at different steps of the surgical procedure inside the vitreous cavity. Temperature control can modulate the rheology of tamponades. TRANSLATIONAL RELEVANCE Intraoperative temperature control can improve neuroprotection during vitreoretinal surgery, induce the vaporization of perfluorcarbon liquid, and change the shear viscosity of silicone oil.