Sub-perfluoro-n-octane injection of ocular viscoelastic device assisted inverted internal limiting membrane flap for macular hole retinal detachment surgery: a novel technique

• Published in: BMC ophthalmology 2020-03, Vol.20 (1), p.116-116, Article 116
• Main Authors: Lai, Chi-Chun, Wu, An-Lun, Chou, Hung-Da, Teh, Wee Min, Chen, Kuan-Jen, Chen, Yen-Po, Liu, Laura, Hwang, Yih-Shiou, Wu, Wei-Chi
• Format: Article
• Language: English
• Subjects: Acuity; Aged; Aged, 80 and over; Basement Membrane - diagnostic imaging; Basement Membrane - physiopathology; Basement Membrane - surgery; Color vision; Endotamponade - methods; Epiretinal Membrane - diagnostic imaging; Epiretinal Membrane - physiopathology; Epiretinal Membrane - surgery; Eye; Female; Fluorocarbons - administration & dosage; Follow-Up Studies; Humans; Injection; Internal limiting membrane; Intravitreal Injections; Laboratories; Macular hole retinal detachment; Male; Middle Aged; Ocular viscoelastic device; Ophthalmology; Patients; Perfluoro-n-octane; Retina; Retinal Detachment - diagnostic imaging; Retinal Detachment - physiopathology; Retinal Detachment - surgery; Retinal Perforations - diagnostic imaging; Retinal Perforations - physiopathology; Retinal Perforations - surgery; Retrospective Studies; Software; Surgery; Surgical Flaps; Surgical outcomes; Surgical techniques; Tomography, Optical Coherence; Viscoelasticity; Visual Acuity - physiology; Vitrectomy
• ISSN: 1471-2415; 1471-2415
• DOI: 10.1186/s12886-020-01393-1

To evaluate the feasibility of a surgical technique using a sub-perfluoro-n-octane (PFO) injection of ocular viscoelastic device (OVD) to stabilize inverted internal limiting membrane (ILM) flap for the treatment of macular hole retinal detachment (MHRD). This study was a retrospective, consecutive, interventional case series. Patients who underwent MHRD surgery with sub-PFO injection of OVD to stabilize inverted ILM flap onto the macular hole (MH) were reviewed. The color fundus and optical coherence tomography (OCT) images were collected and evaluated. The best-corrected visual acuity (BCVA) before and after surgery were compared as the functional outcome. The study included 8 eyes of 8 consecutive patients (mean age: 61.8 ± 7.1 years; mean follow-up period: 9.0 ± 2.5 months). All eyes (100%) achieved successful MH closure; 7 eyes (87.5%) demonstrated complete retinal reattachment, and 1 eye (12.5%) had minimal residual subretinal fluid parafoveally. Of the 8 patients, 7 patients (87.5%) had achieved improvement in BCVA after the primary surgery, whereas 1 eye remained stable. The average BCVA before and after the surgery at the last visit improved from 20/843 (1.63 ± 0.48 logMAR) to 20/200 (1.00 ± 0.39 logMAR) (P = 0.016). Anatomically, near-normal foveal contour was noted in five (62.5%) eyes at the final follow-up. The use of sub-PFO injection of OVD in MHRD surgery could stabilize inverted ILM flaps, achieve good anatomical results and improve postoperative BCVA.