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October 1988

Fluid-Gas Exchange After Vitrectomy Using Long-Acting Gases in an Outpatient Setting

Author Affiliations

Jacksonville, Fla
Ann Arbor, Mich

Arch Ophthalmol. 1988;106(10):1344. doi:10.1001/archopht.1988.01060140508003

To the Editor.  —Postvitrectomy fluid-air exchange is a useful procedure for the treatment of recurrent vitreous hemorrhage and persistent or recurrent retinal detachment. Recently, several reports have described techniques of outpatient fluid-air exchange.1-3 Landers and associates1 described a single syringe and needle "push-pull" technique in which the syringe is filled with air or an air-gas mixture. A similar technique was recently described by Kleiner2 in which two syringes could be attached to a single needle via a special connector. In this way, a long-acting gas such as sulfur hexafluoride or perfluoropropane can be injected. Long-acting gas tamponade is often required in the treatment of proliferative vitreoretinopathy. Furthermore, using slightly expansile concentrations facilitates a more complete gas fill. Unfortunately, these techniques can cause rapid changes in intraocular pressure or, more commonly, the introduction of small bubbles known as "fish eggs." The bubbles often preclude further postoperative laser therapy.

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