Subretinal Sodium Fluorescein Injection and Three-Dimensional Pars Plana Vitrectomy for the Identification of Retinal Breaks.
Enrique López-Sánchez, Lidia Remolí-Sargues, Belén López-Salvador et al.
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Case in brief
Two patients undergoing retinal detachment surgery with the NGENUITY three-dimensional visualization system had retinal breaks that could not be identified during surgery. In each case, up to 0.1 mL of sodium fluorescein (0.1 mg/mL) was injected into the subretinal space by a transscleral or transretinal approach. With an excitation filter and a specific digital color channel, dye extrusion during perfluorocarbon injection revealed the breaks. Standard retinal detachment repair was completed; both retinas were attached at 3 months, with no reported fluorescein-related complications.
What made this case unusual
Subretinal fluorescein extrusion, viewed through a 3D system’s excitation filter and digital color channel, exposed breaks that had not been found by conventional intraoperative inspection.
Diagnostic / clinical pearl
When retinal breaks remain unidentified during retinal detachment surgery, this report describes using subretinal fluorescein extrusion under filtered 3D visualization to help localize them; the technique’s longer-term safety and efficacy remain unconfirmed.