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. 2025 Oct 27;55(5):256-259.
doi: 10.4274/tjo.galenos.2025.20050.

Internal Drainage of Subretinal Fluid Using 25/32 Gauge Cannula in Eyes with Rhegmatogenous Retinal Detachment

Ziya Kapran  1 , Tuğrul Altan  1 , Nur Acar Göçgil  1 , Nihat Sayın  2
Affiliations

Internal Drainage of Subretinal Fluid Using 25/32 Gauge Cannula in Eyes with Rhegmatogenous Retinal Detachment

Ziya Kapran et al. Turk J Ophthalmol. .

Abstract
in English, Turkish

Objectives: To evaluate the safety and efficacy of a modified novel surgical approach for the drainage of subretinal fluid (SRF) during pars plana vitrectomy (PPV) for the repair of rhegmatogenous retinal detachment.

Materials and methods: This retrospective consecutive interventional case series included 15 eyes of 15 consecutive patients who were followed for at least 3 months. All patients underwent 25-gauge (G) PPV with retinal penetration using 25/32G subretinal cannula and SRF aspiration. Laser photocoagulation was not applied around the drainage area in any case. Primary outcomes included visual acuity and the presence of SRF at 1 month.

Results: SRF was not detected in any case at postoperative 1 month. Mean (±standard deviation) logarithm of the minimum angle of resolution visual acuity improved from 1.44±1.11 to 0.43±0.59 at the last visit (p<0.01). Cataract surgery was performed in the same sitting in 5 of 11 phakic eyes (45%). Single-site drainage was effective in 11 eyes (73.4%) while two-site drainage was performed in the remaining 4 eyes (26.6%). Retinal pigment epithelium defects were observed at the drainage site in 3 eyes (20%). During follow-up, redetachment due to proliferative vitreoretinopathy occurred in one case (6.6%) and epiretinal membrane in 2 cases (13.3%). Cataract developed in 3 of the 6 remaining phakic eyes (50%).

Conclusion: Transretinal drainage of SRF with the assistance of 25/32G subretinal cannula is effective with low complication rates. This drainage technique may positively affect early postoperative outcomes.

Amaç: Regmatojen retina dekolmanı tedavisi için uygulanan pars plana vitrektomi (PPV) cerrrahisinde subretinal sıvı (SRS) drenajı için kullanılan yeni bir tekniğin modifikasyonunun güvenilirlik ve etkinliğini değerlendirmek.

Gereç ve yöntem: Çalışma tasarımı retrospektif ardışık girişimsel olgu serisidir. En az 3 ay boyunca takip edilen 15 ardışık hastanın 15 gözü çalışmaya dahil edildi. Tüm hastalara 25 gauge (G) PPV uygulandı. Tüm olgularda SRS drenajı transretinal olarak 25/32G kanül kullanarak yapıldı. Drenaj alanında hiçbir olguda lazer fotokoagülasyon uygulanmadı. Primer kriterler arasında görme keskinliği ve birinci ayda SRS varlığı yer alıyordu.

Bulgular: Birinci ay sonrası hiçbir olguda SRS tespit edilmedi. Ortalama (±standart deviasyon) minimum çözünürlük açısının logaritması görme keskinliği, son ziyarette 1,44±1,11’den 0,43±0,59’a iyileşti (p<0,01). On bir fakik gözden 5’inde (%45) aynı seansta katarakt cerrahisi yapıldı. Onbir gözde (%73,4) tek noktadan drenaj etkili oldu, geriye kalan 4 gözde (%26,6) ise iki noktadan drenaj yapıldı. Üç gözde (%20) drenaj alanında retinal pigment epitel defektleri gözlendi. Takip boyunca 1 gözde proliferatif vitreoretinopatiye bağlı nüks (%6,6) ve 2 gözde epiretinal membran (%13,3). Kalan 6 fakik gözden 3’ünde de (%50) katarakt meydana geldi.

Sonuç: 25/32G subretinal kanül ile SRS drenajı düşük komplikasyon oranlarıyla etkili bir şekilde uygulanabilir. Bu drenaj tekniği erken postoperatif sonuçları olumlu etkileyebilir.

Keywords: Vitrectomy; internal drainage; rhegmatogenous retinal detachment; subretinal cannula; subretinal fluid drainage.

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Conflict of interest statement

No conflict of interest was declared by the authors.

Figures

Figure 1
Figure 1
Penetration of the retina with 25/32G cannula after fluid air exchange where subretinal fluid level is high G: Gauge
Figure 2
Figure 2
Aspiration of subretinal fluid
Figure 3
Figure 3
Near complete aspiration of subretinal fluid with the cannula kept steadily in the same position
Figure 4
Figure 4
Slight gliosis and retinal pigment epithelium damage at the superotemporal drainage site in a patient with macula-off rhegmatogenous retinal detachment
See this image and copyright information in PMC

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