OSLI Retina

October 2018

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800 Ophthalmic Surgery, Lasers & Imaging Retina | Healio.com/OSLIRetina ity 3.5 mm from the inferotemporal limbus. A 5-cc syringe filled with the desired type and concentra- tion of gas or air is attached to a 30-gauge needle. The cannula is entered with the needle, avoiding lens touch in phakic eyes, and then air or gas is injected. Because the needle is of a smaller gauge than the cannula and the valve is held open by the inserted needle, vitreous fluid can egress through the residual space available in the open cannula. The technique is demonstrated in a pseudophakic eye (Figure). This allows for active equilibration of the injection and extrusion volumes, resulting in a consistently normotensive state during the proce- dure and secondarily, stability of the vitreous cav- ity throughout the exchange. After the contents of the 5-cc syringe have been injected, equilibration of the intraocular pressure (IOP) with atmospheric pressure occurs by main- Figure. Fluid-air exchange via a 30-gauge needle and 27-gauge valved cannula. TABLE Snellen Visual Acuity Outcomes Following 27-Gauge Office Air-Fluid Exchange Case Indication Acuity Baseline Acuity Month 1 Acuity Month 3 Follow-Up 1 FTMH after RD repair 20/100 20/100 20/100 12 months 2 VH after PPV CF 20/40 20/40 4 months 3 VH after PPV HM 20/100 20/100 7 months FTMH = full-thickness macular hole; PPV = pars plana vitrectomy; RD = retinal detachment; VH = vitreous hemorrhage; CF = counting fingers; HM = hand motions

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