ABSTRACT
Purpose: To report unprompted closure of spontaneous macular hole secondary to inadvertent subfoveal perfluorocarbon liquid (PFCL) after vitrectomy surgery. Observations. We present a case of a retained large single subfoveal PFCL droplet following vitrectomy and silicone oil injection for subtotal rhegmatogenous retinal detachment that showed spontaneous release 3 weeks postoperatively, with subsequent development of full thickness macular hole (FTMH) which completely closed later on after silicone oil removal without internal limiting membrane peeling with marvelous anatomic and visual improvement after spontaneous closure of MH. Conclusions: Different fates of subfoveal PFCL droplets may happen. Spontaneous release of subfoveal PFCL without surgical interference has rarely been reported.
ABSTRACT
PURPOSE: To report the long-term follow-up of patients with inadvertent retained submacular perfluorocarbon liquid (PFCL) bubbles after vitrectomy surgery. BACKGROUND: PFCL has unique chemical and physical features which facilitate displacement of subretinal fluid from central toward periphery allowing intraoperative reattachment of the mobile retina and manipulation of the anterior part of the detached retina without performing drainage retinotomy. Despite these advantages, PFCL droplets may be inadvertently retained in the submacular space. METHODS: A retrospective case series study was conducted. We reviewed 1224 consecutive patients who had undergone primary pars plana vitrectomy at one vitreoretinal center operated by single surgeon (Hammouda Ghoraba). Chart review was performed to identify patients and procedural factors that could predispose to retained submacular PFCL with anatomical and functional outcomes with follow-up at least 18 months. RESULTS: The retina was completely attached in 97% of eyes where PFCL was used after one or two vitrectomy surgeries. Submacular PFCL was found in 12 (0.98%) eyes. There was no statistical difference between perfluorodecalin and perfluoro-n-octane as regards retention rate. The possible risk factors associated with submacular retention of PFCL phenomenon are the presence of post-equatorial retinal breaks in six patients (50%) and large retinal break (2-3 clock hours) in three patients (25%). CONCLUSIONS: Submacular PFC migration occurs in nearly 1% of cases when it is used. It occurred in cases of RRD with post-equatorial or large breaks. Using perfluoro-n-octane or perfluorodecalin had no statistical difference. Different behaviors of submacular PFC droplets occurred. Some cases of small submacular PFC droplets maintained fair VA for a long period.
