MINIMAL INVASIVE DRAINAGE TECHNIQUE FOR LARGE EXPANDING SUBRETINAL GAS BUBBLE.

PURPOSE: To report a minimally invasive drainage technique for large expanding subretinal gas bubble and conduct a review of the literature.

METHODS: Case report, with schematic diagrams and multimodal imaging including fundus photography and spectral domain optical coherence tomography. Controlled drainage of large subretinal gas bubble using a 30-gauge needle introduced through cryotherapy-treated area in office-based setting.

RESULTS: Forty-year-old male patient presented with bullous rhegmatogenous retinal detachment and had gas inadvertently injected into the subretinal space during cryo-pneumatic retinopexy. After successful drainage of subretinal gas in clinic, 0.3cc of perfluoropropane (C3F8) gas was injected in different quadrants near the attached retina. The macula remained attached on immediate fundus examination. The gas bubbles of fish eggs coalesced into a single large bubble within 1 week. Spectral domain optical coherence tomography showed unremarkable foveal scans. After 45 days, the gas bubble completely disappeared, the retina remained attached, and vision in the treated eye was 20/20.

CONCLUSION: To the best of our knowledge, this is the first case report of a large expanding gas bubble injected into the subretinal spaces being drained successfully by the described minimal invasive technique. Although it may offer a possible office-based approach to a rare complication, it is generally recommended that surgeons capable of dealing with its possible complications may attempt such technique when immediate vitrectomy is not accessible.