Tamponades

As the VR surgeon removes gel from the vitreous cavity, he typically replenishes it with BSS. Gaseous materials or fluids, in addition to being used as intraoperative tools, may be employed as “tamponade,” kept postoperatively for weeks or months or permanently.1 During the operation, several exchanges between these materials may need to be performed.

35.1Air

Air in the VR surgeon’s hands has many uses (see Sect. 14.1), of which retinal reattachment (F-A-X, see Sect. 31.1) is the most important. Air, which does not expand after implantation,2 is rarely used3 as a postoperative tamponade since it disappears from the vitreous cavity within days.

Pearl

The air should never be injected at high pressure to avoid retinal damage by the jet stream, and it must be filtered first (Millipore 0.22 μ, EMD Millipore, Billerica, MA, USA).

1Chapter 14 provides additional information about these materials.

2Unless the patient is at high altitude; see below.

3Some surgeons tried it in macular hole surgery, but the initial enthusiasm for air use has subsided.

F. Kuhn, Vitreoretinal Surgery: Strategies and Tactics,

DOI 10.1007/978-3-319-19479-0_35