Identification of retinal breaks using subretinal trypan blue injection
Identification of retinal breaks using subretinal trypan blue injection
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DOI：
10.1016/j.ophtha.2006.05.079
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发表时间：
2007-03-01
期刊：
影响因子：
13.7
通讯作者：
Aylward, William
中科院分区：
文献类型：
--
作者：
Jackson, Timothy L.;Kwan, Anthony S. L.;Aylward, William
目的：描述视网膜下台盼蓝在孔源性视网膜脱离(RD)玻璃体切除术中识别视网膜裂孔的应用。设计：干预性病例系列。参与者：5例RD患者，经巩膜凹陷内搜索未发现视网膜裂孔。方法：使用专为黄斑移位手术设计的41号插管将台盼蓝0.15%经视网膜注入视网膜下间隙。然后将全氟碳重液注入玻璃体腔，旋转眼睛，使台盼蓝从裂口中排出。台盼蓝的羽流被用来识别视网膜裂隙，或者在某些情况下，裂隙的染色有助于裂隙的检测。然后通过裂孔引流视网膜下液或引流视网膜切开术，并使用标准技术完成手术。主要观察指标：识别以前未见的视网膜裂孔。结果：该技术在5例患者中成功识别出4例视网膜裂孔。在吸收气体填充后，所有视网膜仍然附着，中位视力为6/12。结论：在RD手术中未能识别视网膜裂孔是公认的临床挑战，可能会对预后产生不利影响。在这种情况下，发色团辅助的视网膜裂孔检测可能是一种有用的手术技术。
Purpose: To describe the use of subretinal trypan blue to identify retinal breaks during vitrectomy for rhegmatogenous retinal detachment (RD).Design: Interventional case series.Participants: Five patients with RD in whom no retinal break could be identified by internal search with scleral indentation.Methods: Trypan blue 0.15% was injected transretinally into the subretinal space using a 41-gauge cannula designed for macular translocation surgery. Perfluorocarbon heavy liquid was then injected into the vitreous cavity and the eye was rotated such that trypan blue was vented out of the break. The plume of trypan blue was used to identify retinal breaks, or in some cases staining of the break facilitated break detection. Subretinal fluid was then drained through the break or a drainage retinotomy and surgery was completed using standard techniques.Main Outcome Measure: Identification of previously unseen retinal breaks.Results: This technique successfully identified a retinal break in 4 out of 5 patients. After absorption of the gas tamponade all retinas remained attached with a median visual acuity of 6/12.Conclusion: Failure to identify a retinal break during RD surgery is a well-recognized clinical challenge that may adversely affect outcome. In this setting, chromophore-assisted retinal break detection may be a useful surgical technique.