Proper positioning helps avoid displacement after giant retinal tear surgery
FORT LAUDERDALE, Fla. — Proper positioning directly after surgery is key to preventing displacement when treating giant retinal tears, according to a speaker here.
At the Retina World Congress, Niels Crama, MD, FEBO, said that air is his first choice of tamponade but that he sometimes uses SF6 20% or silicone oil 5700 cs. Slippage can be avoided by performing position-guided fluid-air exchange during surgery.
Crama also said that it is important to remove the internal limiting membrane.
“I make sure that at the end when I remove the [perfluorocarbon liquid] that there’s just air in the eye,” he said. “I have to say that with the right position, you will overcome slippage.”
Positioning should be done on the side of the tear for 30 minutes directly after surgery. Crama advises patients to sleep on the cheek opposite of the tear for 3 nights. For patients with or at risk for proliferative vitreoretinopathy, silicone oil 5700 cs should be used and can be removed after a period of 6 to 8 weeks, Crama said.
“I say 6 to 8 weeks, but sometimes you can remove the oil earlier because you just need the tamponade for a short period of time,” he said. “If you leave it in for too long, you have a higher risk for macular edema and other problems.”
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Crama N. Management of giant retinal tear detachments. Presented at: Retina World Congress; May 12-15, 2022; Fort Lauderdale, Fla.
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