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Efficacy of fluid-air exchange during pars plana vitrectomy
J S Rubin1, J T Thompson, R N Sjaarda
1Retina Institute of Maryland, Baltimore, USA.
Purpose:
Vitreous fluid that remains trapped in the peripheral vitreous cavity after vitrectomy with fluid-air exchange can result in a smaller than desired intravitreal gas bubble size. To evaluate the effectiveness of a single fluid-air exchange in dehydrating the vitreous cavity, we measured the rate and volume of posterior vitreous fluid migration after an initial fluid-air exchange.
Methods:
Thirty-eight eyes undergoing vitrectomy for macular hole closure had measurements of posterior vitreous fluid accumulation at either 5, 10, 15, or 20 minutes after fluid-air exchange.
Results:
An average of 0.38 ml of fluid accumulated posteriorly within 10 minutes after the initial fluid-air exchange compared to 0.22 ml that accumulated after 5 minutes (P = 0.0003). A mean of 0.04 ml accumulated during each 5-minute interval between 10 and 20 minutes after the initial fluid-air exchange.
Conclusion:
Fluid composing 10% of the vitreous volume may migrate and accumulate posteriorly within 10 minutes of an apparently complete fluid-air exchange. Fluid aspiration after a 10-minute wait after the initial fluid-air exchange helps maximize vitreous cavity dehydration and should be employed when a large gas bubble is required after vitrectomy.