Minimally Invasive Subretinal Perfluorocarbon Liquid (PFCL) Removal

Area of Science:

• Ophthalmology
• Retinal Surgery
• Surgical Innovation

Background:

• Perfluorocarbon liquid (PFCL) is essential in retinal surgery but can lead to subretinal retention, potentially damaging the fovea.
• Current methods for removing retained PFCL are varied, with ongoing research into safer and more effective approaches.

Purpose of the Study:

• To investigate the efficacy of microneedles for aspirating retained perfluorocarbon liquid (PFCL) from the subretinal space.
• To evaluate the performance of different gauge microneedles in PFCL aspiration using in vitro, ex vivo, and in vivo models.

Main Methods:

• In vitro aspiration rates of PFCL using 30, 41, 43, and 49 gauge needles were measured.
• Ex vivo porcine models were used to assess subretinal PFCL aspiration consistency and needle blockage.
• The technique was applied in 10 patients undergoing pars plana vitrectomy (PPV) for retained subfoveal or parafoveal PFCL.

Main Results:

• Microneedle aspiration of PFCL was successful, with varying aspiration times depending on needle gauge and vacuum pressure.
• Ex vivo models demonstrated repeatable PFCL aspiration without blockage using 400-650 mm Hg vacuum.
• All 10 patients treated with microneedle aspiration achieved successful outcomes, with a mean visual acuity change of LogMAR -0.08.

Conclusions:

• Microneedles represent a viable, minimally invasive surgical option for direct removal of retained perfluorocarbon liquid.
• The study successfully validated microneedle performance from in vitro to clinical application for PFCL aspiration.