Dr.Kushal Umeshbhai Agrawal, Dr.Jay Kumar Chhablani, Dr.Ina Budhiraja
A 71-year old male diabetic patient, presented with non-resolving vitreous haemorrhage under silicon oil of 2 months duration, 1 month post uneventful vitrectomy for ERM with traction on macula and VH. Removal of sub-silicone oil haemorrhage along with silicone oil exchange was planned. After silicone oil removal view was very hazy because of continuous bleeding into the vitreous cavity.
To overcome this, fluid air exchange was done and further vitrectomy was performed under air infusion. Due to tamponade by the air, the bleeding stopped and blood clots could be better visualised. All blood clots were removed gently avoiding the pull on the retina. At the end of the surgery, attached retina under oil with laser marks was seen.
Refractive index of air is 1.00 and that of balanced salt solution is 1.33, so, wider view of retina could be seen under air compared to fluid .Air reduces unwanted retinal motion so chances of iatrogenic breaks are less as compared to standard vitrectomy.