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. 2018 Jul;66(7):988-990.
doi: 10.4103/ijo.IJO_1294_17.

Sandwich technique using a combination of perfluoropropane and silicone oil for inferior retinal detachment

Sumit Randhir Singh  1 , Deven Dhurandhar  1 , Jay Chhablani  1
Affiliations

Sandwich technique using a combination of perfluoropropane and silicone oil for inferior retinal detachment

Sumit Randhir Singh et al. Indian J Ophthalmol. 2018 Jul.

Abstract

We report a novel surgical sandwich technique using a combination of intraocular perfluoropropane (C3F8) and silicone oil for inferior retinal detachment (RD). After conventional pars plana vitrectomy and posterior vitreous detachment induction, fluid-gas exchange using 14% C3F8was done. This was followed by silicone oil injection using automated infusion pump to 50% fill of the vitreous cavity under direct visualization to achieve formation of two bubbles - gas bubble superiorly and silicone oil inferiorly. The patient was subsequently asked to maintain upright position. The two immiscible bubbles of C3F8and silicone oil provide tamponade to superior and inferior retina, respectively. With time, gas bubble reduces in size with a gradual superior shift of silicone oil. This novel sandwich technique achieves complete attachment of retina and reduces the risk of retinal redetachment in inferior RDs by adequately tamponading the inferior retina.

Keywords: Inferior retinal detachment; perfluoropropane; proliferative vitreoretinopathy; sandwich technique; silicone oil.

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Conflict of interest statement

There are no conflicts of interest

Figures

Figure 1
Figure 1
(a) The diagrammatic representation of eye completely filled with 14% perfluoropropane with attached retina. (b) Sandwich filling of silicone oil (1/2) and intraocular gas perfluoropropane (1/2)
Figure 2
Figure 2
A wide-field fundus image of a patient who underwent sandwich technique for retinal detachment associated with inferior retinal break, showing attached retina, flat inferior breaks, and half-filled silicone oil. The patient was a 51-year-old male who had a history of diminution of vision in right eye for past 4 months. Fundus showed the presence of rhegmatogenous retinal detachment with multiple inferior breaks and early proliferative vitreoretinopathy changes. He underwent retinal detachment repair using sandwich technique. After the sandwich technique, the patient maintained upright position for 2 weeks. Best-corrected visual acuity at 2 months follow up improved to 20/80 with attached retina
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