Tip to remove multiple small PFCL bubbles

Perfluorocarbon liquid (PFCL) is used to float a dislocated lens in the vitreous cavity. On performing phacofragmentation to remove it, multiple small bubbles of PFCL may form and these may be difficult to remove from [Fig. 1a] the retinal surface. We found that on reinjecting a larger single bubble of PFCL, these small bubbles coalesce into a single bubble [Fig. 1b], making them much easier to be removed [Fig. 1c and 1d]. We also carried out a phaco experiment in PFCL and found that small PFCL droplets were produced during the phaco process [Fig. 2a-2c].Figure 1: (a) Multiple small PFCL bubbles on the retinal surface. (b) A larger single bubble of injected PFCL causing the small bubbles to coalesce into it. (c) The single large bubble that is easier to remove. (d) No residual PFCLFigure 2: (a) PFCL in a vitreous bottle. (b) Phaco probe into the PFCL. (c) A large number of smallPFCL bubbles were produced during the phaco processDiscussion Since it was first reported by Chang[1] in 1987, PFCL, as a "liquid operation tool" in vitreoretinal surgery, has been widely used in complicated retinal detachment surgery and removal of dislocated lenses. However, a potential complication of PFCL is that it can remain in the eye, causing retinal toxicity.[2] Conventional vitreous cutter or flute needle cannot completely remove all small fish bubbles, and attempting to remove them can cause iatrogenic retinal holes. Therefore, we propose a new surgical technique to solve this problem, that is, reinjecting PFCL to remove multiple small PFCL bubbles on the retinal surface. The small bubbles coalesce due to intermolecular attraction. We found this method to be very effective in removing multiple residual PFCL bubbles on the retinal surface, which is worth promoting. Financial support and sponsorship: Nil. Conflicts of interest: There are no conflicts of interest.