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Comparative Study
. 2025 Feb 1;45(2):257-268.
doi: 10.1097/IAE.0000000000004309.

TRANSRETINAL PUNCTURE WITH A 41G CANNULA FOR POSTERIOR RESIDUAL SUBRETINAL FLUID IN FOVEA-OFF RETINAL DETACHMENTS TREATED BY VITRECTOMY VS FLUID TOLERANCE VS OTHER CONVENTIONAL DRAINAGE TECHNIQUES: A Comparative Study

Maxime Desira  1 , Thibault Ruiz  1 , Alban Comet  1   2   3 , Frederic Matonti  2   3   4 , John Conrath  2   3 , Robinson Gravier-Dumonceau  5 , Charles Delaporte  1 , Christophe Morel  2   3 , François Devin  2   3 , Thierry David  1 , Pierre Gascon  1   2   3
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Comparative Study

TRANSRETINAL PUNCTURE WITH A 41G CANNULA FOR POSTERIOR RESIDUAL SUBRETINAL FLUID IN FOVEA-OFF RETINAL DETACHMENTS TREATED BY VITRECTOMY VS FLUID TOLERANCE VS OTHER CONVENTIONAL DRAINAGE TECHNIQUES: A Comparative Study

Maxime Desira et al. Retina. .

Abstract

Purpose: To compare functional and anatomical outcomes between posterior drainage of residual fluid using a 41G cannula, fluid tolerance (residual subretinal fluid), and conventional complete drainage methods, including removal through peripheral retinal breaks, perfluorocarbon liquid, and posterior retinotomy.

Methods: In this retrospective, multicenter study, we evaluated cases for visual acuity at 3 months of follow-up. Secondary outcomes included surgical success, postoperative metamorphopsia, shifts, full-thickness folds, optical coherence tomography parameters, and safety. Subgroup analyses were also conducted.

Results: Visual acuity did not differ significantly between the three main groups. Subgroup analyses revealed worse visual acuity for posterior retinotomy (20/270 in Snellen conversion, P = 0.002), with significantly more Grade C proliferative vitreoretinopathy (40.0%, P = 0.003). Residual subretinal fluid tended to offer better secondary outcomes, without statistical significance except for postoperative epiretinal membrane (30.8%, P = 0.041). Subgroup analyses found significantly more shifts with PFCL (91.7%, P = 0.036). No cases of postoperative full-thickness folds or macular holes were observed with the 41G.

Conclusion: Our study introduced the 41G technique, indicating favorable outcomes for fovea-off retinal detachments. Nevertheless, fluid tolerance appeared to be the best option, offering a cost-effective and faster method, with an optimal microstructural profile and visual acuity comparable with that of complete drainage techniques.

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