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    Viscoelastic Substance as an Adjuvant Agent in Complicated Pars Plana Vitrectomy

    AAO 2019 Video Program
    Retina/Vitreous

    Surgery of open globe injury with closed funnel-shaped retinal detachment (RD) and proliferative diabetic retinopathy with extensive epiretinal membrane (ERM) or tractional RD can be very time consuming and will result in a mess virtually every time. If used appropriately, viscoelastic can efficiently help open a closed funnel or create a potential space between a tightly adherent ERM and the retina, and greatly shorten the surgical time. This video will show three cases involving use of viscoelastic. Case 1 is a severe blunt trauma with scarce and detached retina as a closed funnel. Case 2 is another open globe injury, also with a closed funnel-shaped RD, but the retina is abundant. You will see the retina is opened with injection of viscoelastic like an opening blossom. The key point to retract viscoelastic is the cautious use of perfluoro-n-octane. Case 3 shows a proliferative diabetic retinopathy with extensive C-shaped ERM tightly adherent to the retina. This case will show how viscoelastic can help create the space between the ERM and the retina very efficiently, without obvious hemorrhage.