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Effect of expansile gas bubble following pars plana vitrectomy on retinal displacement

Session Details

Session Title: Quick Fire Free Paper 3

Session Date/Time: Thursday 11/09/2014 | 14:30-16:00

Paper Time: 15:45

Venue: Boulevard D

First Author: : Z.Elhousseini UK

Co Author(s): :    A. Laidlaw   E. Lee           

Abstract Details

Purpose:

to evaluate if the use of expansile small gas bubble as a temponade following pars plana vitrectomy (PPV), reduces unintentional retinal shift noticed on autoflourescence imaging

Setting:

retrospective study carried at St Thomas’ hospital, London, UK

Methods:

15 patients with a macular off retinal detachment underwent PPV by the same surgeons and the same center. Patients were divided into 2 groups either retinal detachment bisecting the fovea or beyond the fovea. Gas fluid exchange was not performed and a small expansile gas bubble (100% concentration) was injected after sealing the ports, then all patients had to posture for 2 hours on the side of the fluids. Outcome included patients’ age, gender and laterality. Auto fluorescence imaging (AF) was performed at least 2 weeks after the operation to monitor retinal shift. The images were evaluated for a shift by 2 separate researchers and any doubtful images were refereed by a third researcher. 25 autoflourescence images of patients who underwent PPV, fluid air exchange and full gas bubble were used as controls

Results:

Age of the patients ranged from 47-83 years old (median = 54),11 males and 4 females,7 right eyes and 8 left eyes. Out of the 15 patients with fovea involving retinal detachment, 5 patients had RD bisecting the fovea and 10 eyes had RD extending beyond the fovea. Different volumes of gas were used according to the half lives of each gas (1.5ml SF6, 1ml C2f6 and 0.5ml C3F8). Only 5 out 15 eyes showed a retinal displacement (33%) compared to 16 out 25 eyes (68%) who underwent full fluid air exchange. On subjective basis, in the expansile gas group retinal vessels shift on AF images tends to be less notable in comparison to controls. 2 patients required reinjection of gas bubble in the first post op day, and 1 operation failed and required reoperation. Primary success rate was 93.3%. No statistical importance was found between the different groups which is probably because of the small number of patients

Conclusions:

the use of small expansile gas bubble at the end of PPV may aid in reducing the unintentional retinal shift which is noticed more in full fluid gas exchange in retinal detachment. Larger number study is needed to evaluate whether a small bubble use is statistically significant

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