Prospects of Temperature Management in Vitreoretinal Surgery

Currently, there are no clear recommendations about the safety of certain temperature conditions for intraocular structures during vitreoretinal surgery; instructions on the safe rate of rewarming of the vitreous cavity; and the advisability of monitoring ocular temperature in the postoperative period. The purpose was to study the dynamics of epibulbar and intraocular temperature during vitreoretinal surgery. This study included 20 patients with rhegmatogenous retinal detachment (10 eyes) and retinal detachment associated with proliferative diabetic retinopathy (10 eyes). All patients underwent vitreoretinal surgery. In all cases, the ambient temperature, the patient's body temperature, the temperature of the irrigating solution, and temperature in the anterior, mid-, and posterior vitreous were recorded during surgery. Pre- and postoperative thermometry was also performed on the outer ocular surface. During vitreoretinal surgery with room temperature irrigation solution, a decrease in temperature (p < 0.001) versus the initial one was found in all segments of the vitreous cavity. In the absence of continuous irrigation, a rapid rewarming of the vitreous cavity was noted (an average of 0.18°C/min). Our study also demonstrated the presence of regional hyperthermia of the operated eye in a number of patients (25%) in the postoperative period. Current research shows that vitreoretinal surgery is performed under conditions of uncontrolled local ocular hypothermia and is characterized by a rapid uncontrolled rewarming of the vitreous cavity after cessation of cooling, and in the postoperative period local hyperthermia of the operated eye is observed in a number of patients.