Steven T. Charles
NEW ORLEANS — The reattachment sequence when performing retinectomy should not be done under balanced salt solution but rather under air, according to Steven T. Charles, MD.
“I don’t ever do this under infusion fluid, under [balanced salt solution], and I think it’s a mistake to do that,” he said.
Charles reviewed his preferences for when and how to perform retinectomy at Retina Subspecialty Day preceding the American Academy of Ophthalmology meeting.
When oil is in the eye, Charles said he reoperates under oil.
“In that case I don’t remove the oil or put in [perfluoro-n-octane],” Charles said. “It’s either under air or under oil; it’s never under [balanced salt solution], never under PFO.”
Performing retinectomy under fluid can create retinal movement, resulting in excessive or insufficient retinectomy, he said.
Charles’ controlled incremental method minimizes retinal movement. In brief, the sequence is to first remove frontal plane vitreous traction and anterior loop traction, followed by epiretinal peeling, removal of subretinal bands, internal drainage of subretinal fluid and fluid-air exchange.
“I can’t tell you how many times I thought a patient needed a retinectomy and when I did this sequence, turns out they didn’t. And, crucial to that is doing all these steps under air,” Charles said. “Think of it as a sequence of events as opposed to a predetermination that you’re going to do a retinectomy.” – by Patricia Nale, ELS
Charles ST. Retinectomy: When and how. Presented at AAO Subspecialty Days; Nov. 10-11, 2017; New Orleans.
Disclosure: Charles reports no relevant financial disclosures.