Modified Surgical Method: Complete Posterior Vitreous Detachment Induction in Pediatric Patients during Vitrectomy using Perfluorocarbon Liquid and Forceps.

Abstract

Purpose: To introduce a modified induction method for complete posterior vitreous detachment (PVD) in pediatric vitrectomy using perfluorocarbon liquids (PFCLs) and forceps.

Methods: This is a case series of a new method to induce PVD in pediatric patients. After an unsuccessful attempt at PVD induction, triamcinolone was used to stain the vitreous, small drops of PFCL were injected, and the vitreous stalk was pinched and grasped at the optic nerve head (ONH). After successful induction of vitreous detachment from ONH, more PFCL was added in increments of approximately two-disc diameters each time to progressively extend the PVD toward the vitreous base using forceps until complete detachment was achieved.

Results: Successful PVD induction was achieved in three patients undergoing pars plana vitrectomy. A 40-day-old infant was referred due to rhegmatogenous retinal detachment (RRD) with a giant retinal tear after a lensectomy. Furthermore, a 3-year-old boy with RRD, pathologic myopia, and mature cataract underwent PVD induction using the method described above. The last case was a 7-year-old girl with old RRD, macular coloboma, and mature cataract.

Conclusions: This technique represents an initial feasibility report suggesting that PFCL-assisted forceps induction may be a practical and accessible method for PVD induction in pediatric vitrectomy. The findings remain preliminary and require validation in a larger series of patients.