Subretinal injection under perfluorocarbon liquids to avoid
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To describe a novel method of subretinal injection to reduce the risk of foveal dehiscence during subretinal tissue plasminogen activator (TPA) delivery for submacular hemorrhage a study was conducted. Findings suggested that the technique allows the creation of a low more diffuse subretinal bleb compared to without perfluorocarbon liquid, minimizing hydraulic stress on the fovea during injection and could be applied to other subretinal injection scenarios where the fovea is at risk of a hydraulic blowout

Four cases have been treated with controlled subretinal injection extending under the fovea without dehiscence, including one case with apparent pre-existing foveal dehiscence and a pre retinal clot. The subretinal injection is delivered under a perfluorocarbon liquid (PFCL) bubble filling 80% of the vitreous cavity to 4 patients. An eccentric injection point is used and the tissue plasminogen activator injected under a pneumatically controlled viscous fluid injection system with a 38g polyimide cannula and low injection pressure.

Source:https://journals.lww.com/retinajournal/Abstract/9000/Subretinal_injection_under_perfluorocarbon_liquids.95594.aspx
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