"Micro-Viscous Fluid Control": A Simple Homemade New Tool to Access Subretinal Space in a Controlled Way.

Purpose: To develop a simple tool to remove retained submacular perfluorocarbon liquid bubbles (R-PFCL) and to inject recombinant tissue plasminogen activator safely in subretinal space in submacular hematomas.

Method: A retrospective, interventional study was performed where a simple homemade micro-viscous fluid control was developed to gain access to subretinal space in a controlled way. The rubber cap of the plunger of a 1-mL syringe was cut; this cut rubber cap of the plunger was fitted inside an empty 1-mL tuberculin syringe, and its end was fitted with the tubings of viscous fluid control of the vitrectomy machine. Now, viscous fluid control mode was activated by attaching a 38-G/41-G subretinal needle for extracting submacular PFCL bubbles (R-PFCL group, n = 12) and to deliver recombinant tissue plasminogen activator injection in significant submacular hematomas cases (submacular hematomas group, n = 32). Best-corrected visual acuity (BCVA), fundus photographs, and optical coherence tomography were analyzed. Follow-up was done for at least 6 months.

Results: Vision improved from preoperative mean BCVA logarithm of the minimum angle of resolution 0.99 (20/195) ± 0.27 to postoperative mean BCVA logarithm of the minimum angle of resolution 0.75 (20/112) ± 0.21 (P-value < 0.05) in R-PFCL group and from preoperative mean BCVA logarithm of the minimum angle of resolution 1.99 (20/1954) ± 0.75 to postoperative mean BCVA logarithm of the minimum angle of resolution 0.75 (20/112) ± 0.37 (P-value < 0.001) in submacular hematomas group.

Conclusion: Our homemade micro-viscous fluid control is a safe tool to extract retained submacular PFCL bubbles and to deliver a precise dose of subretinal drugs like recombinant tissue plasminogen activator for a subretinal hematoma in a controlled way.