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January 1992

The Steamroller Maneuver and Proliferative Vitreoretinopathy

Arch Ophthalmol. 1992;110(1):15. doi:10.1001/archopht.1992.01080130017008

To the Editor.  —Griffiths and Richardson,1 commenting on potential problems with the steamroller maneuver (this maneuver consists of flattening a retinal detachment using an injected intravitreal gas bubble to squeeze subretinal fluid from the subretinal space into the vitreous cavity), have observed a "marked increase in vitreous flare and pigment cells." Referring to the article by Hackett et al,2 they suggest that this "dumping" of subretinal fluid into the vitreous cavity is unique to pneumatic retinopexy and may promote proliferative vitreoretinopathy (PVR).We agree with Griffiths and Richardson that subretinal fluid cannot be regarded as an inert fluid, and recommend the steamroller maneuver only under very special circumstances.3 We have emphasized the importance of deferring cryopexy until after the steamroller maneuver is performed, to minimize this potential displacement of cryopexy-loosened viable retinal pigment epithelial cells into the vitreous cavity. We have noted increased pigment cells in the