Giant retinal tears: retinal edges and choice of tamponade скачать в хорошем качестве

Giant retinal tears: retinal edges and choice of tamponade

Giant retinal tear is defined as a retinal break larger than 90°. Most GRTs are idiopathic in aetiology, although several risk factors include genetic conditions as Stickler and Marfan syndrome and also trauma, young age, high myopia, aphakia, pseudophakia. Because of their size, we need to keep more attention to the retinal edges that tend to roll back posteriorly and have radial extensions, moreover they have higher prevalence of PVR in about 12-15% of the cases. The retinal edges of the break are the key point to evaluate during the surgery. The aim is to have flat retinal edges on the choroidal plane under air. The PFCL facilitates the unfolding and stabilization of the retina during the management of the edges. Moreover, it is safer to inject PFCL under air, because you have less chance that it goes under the retina (being the retina free from tractions by the vitrectomy and pushed by the high IT of the air) The key to the reasoning is the following: the air has an IT on the BSS that is high (70 mN / m), therefore the air immediately closes the break and creates retinal folds for the residual BSS. Instead the presence of PFCL squeezes the liquid towards the break due to its density (1.9 g / ml) and its IT 50 mN/m with BSS. Whereas in the presence of PFCL and Air, the liquid will be squeezed between the two hydrophobic compounds and then easily collected by the flute needle. At that point, look closely, when PFCL comes into contact with air in the absence of BSS, the PFCL meniscus immediately becomes flat as the IT PFCL-Air collapses to about 25 mN/m Wide-angle visualization systems is also very useful in these cases.