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Case Reports
. 2018 Aug 31;9(2):405-410.
doi: 10.1159/000492746. eCollection 2018 May-Aug.

Case Series of Inappropriate Concentration of Intraocular Sulfur Hexafluoride

Piotr Kanclerz  1 , Andrzej Grzybowski  2   3
Affiliations
Case Reports

Case Series of Inappropriate Concentration of Intraocular Sulfur Hexafluoride

Piotr Kanclerz et al. Case Rep Ophthalmol. .

Abstract

Due to high complexity, vitreoretinal surgery presents a higher number of patient safety incidents compared with other ophthalmic procedures. Intraocular gases are one of the most useful adjuncts to vitrectomy and surprisingly, surgeons commonly admit to having occasional problems with incorrect gas concentration. The aim of this study is to present a consecutive case series of patients with improper concentration of sulfur hexafluoride (SF6) applied during vitrectomy. Three patients underwent 27-gauge vitrectomy and at the end of surgery inappropriate dilution of 100% SF6 was administered. It was attributed to a calculation error, change in the gas supplier, or increased partial pressure of SF6 before dilution. Postoperatively, due to IOP increase, two eyes required intravitreal gas-air exchange. Subsequently, cataract surgery was performed in one eye with concomitant vitrectomy and silicone oil tamponade due to retinal detachment. To prevent such complications, we suggest using intraocular gases with great care, training of ophthalmic personnel, and prompting manufacturers to provide SF6 in a prepared concentration of 20%.

Keywords: Expandable gas; Intraocular pressure; Intraocular tamponade; Sulfur hexafluoride; Vitrectomy.

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Figures

Fig. 1.
Fig. 1.
Slit lamp examination of a patient with significant intraocular pressure increase after SF6 tamponade. Ballooning of the bulbar conjunctiva, corneal edema, and diffuse shallowing of the anterior chamber is observed (photo by the author).
See this image and copyright information in PMC

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