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TRANSRETINAL PUNCTURE WITH A 41G CANNULA FOR POSTERIOR RESIDUAL SUBRETINAL FLUID IN FOVEA-OFF RETINAL DETACHMENTS
Maxime Desira1, Thibault Ruiz1, Alban Comet1,2,3
1Department of Ophthalmology, Aix-Marseille University, Hôpital Nord, Marseille, France.
Purpose:
To compare functional and anatomical outcomes between posterior drainage of residual fluid using a 41G cannula, fluid tolerance (residual subretinal fluid), and conventional complete drainage methods, including removal through peripheral retinal breaks, perfluorocarbon liquid, and posterior retinotomy.
Methods:
In this retrospective, multicenter study, we evaluated cases for visual acuity at 3 months of follow-up. Secondary outcomes included surgical success, postoperative metamorphopsia, shifts, full-thickness folds, optical coherence tomography parameters, and safety. Subgroup analyses were also conducted.
Results:
Visual acuity did not differ significantly between the three main groups. Subgroup analyses revealed worse visual acuity for posterior retinotomy (20/270 in Snellen conversion, P = 0.002), with significantly more Grade C proliferative vitreoretinopathy (40.0%, P = 0.003). Residual subretinal fluid tended to offer better secondary outcomes, without statistical significance except for postoperative epiretinal membrane (30.8%, P = 0.041). Subgroup analyses found significantly more shifts with PFCL (91.7%, P = 0.036). No cases of postoperative full-thickness folds or macular holes were observed with the 41G.
Conclusion:
Our study introduced the 41G technique, indicating favorable outcomes for fovea-off retinal detachments. Nevertheless, fluid tolerance appeared to be the best option, offering a cost-effective and faster method, with an optimal microstructural profile and visual acuity comparable with that of complete drainage techniques.
