Surgical Removal of Submacular Perfluorocarbon Liquid Using a 41-Gauge Extendible Subretinal Injection Needle


Submacular perfluorocarbon liquid (PFCL) retention is a well-known complication of vitreoretinal surgeries; however, the optimal surgical technique for the removal of subfoveal PFCL is yet to be determined. We describe a novel surgical technique for the removal of retained submacular PFCL by performing a retinotomy adjacent to the inferotemporal arcade using a 41-gauge extendible subretinal injection needle and inducing a therapeutic retinal detachment. Through the same retinotomy, the bent 41-gauge needle was advanced into the subretinal space to reach the PFCL bubble. Subsequently, active aspiration of PFCL was performed. The surgical procedure was successfully performed in two patients. This technique appears to be an effective surgical approach for removing retained submacular PFCL bubble.


Subretinal Injection Needle; Subretinal Perfluorocarbon Liquid; Vitrectomy

1. Shulman M, Sepah YJ, Chang S, Abrams GW, Do DV, Nguyen QD. Management of retained subretinal perfluorocarbon liquid. Ophthalmic Surg Lasers Imaging Retina 2013;44:577–583.

2. Garcia-Valenzuela E, Ito Y, Abrams GW. Risk factors for retention of subretinal perfluorocarbon liquid in vitreoretinal surgery. Retina 2004;24:746–752.

3. Georgalas I, Ladas I, Tservakis I, Taliantzis S, Gotzaridis E, Papaconstantinou D, et al. Perfluorocarbon liquids in
vitreoretinal surgery: A review of applications and toxicity. Cutan Ocul Toxicol 2011;30:251–262.

4. Elsing SH, Fekrat S, Green WR, Chang S, Wajer SD, Haller JA. Clinicopathologic findings in eyes with retained
perfluoro-n-octane liquid. Ophthalmology 2001;108: 45– 48.

5. Le Tien V, Pierre-Kahn V, Azan F, Renard G, Chauvaud D. Displacement of retained subfoveal perfluorocarbon liquid after vitreoretinal surgery. Arch Ophthalmol 2008;126:98–101.

6. Ting DS, Lu VH-J, Tan GS, Wong EY. A surprising visual improvement following a prolonged 5-month retained subfoveal perfluorocarbon liquid. Int J Ophthalmol 2016;9:1079–1081.

7. Sakurai E, Ogura Y. Removal of residual subfoveal perfluoro-n-octane liquid. Graefes Arch Clin Exp Ophthalmol 2007;245:1063–1064.

8. Roth DB, Sears JE, Lewis H. Removal of retained subfoveal perfluoro-n-octane liquid. Am J Ophthalmol

9. García-Arumí J, Castillo P, López M, Boixadera A, MartínezCastillo V, Pimentel L. Removal of retained subretinal
perfluorocarbon liquid. Br J Ophthalmol 2008;92:1693–1694.

10. De Cillà S, Alkabes M, Radice P, Carini E, Mateo C. Direct transretinal removal of subfoveal perfluorocarbon liquid: The role and timing of internal limiting membrane peeling. Eur J Ophthalmol 2017;27:249–252.

11. Joondeph BC. Controlled aspiration of subfoveal perfluorocarbon liquid using a novel microcannula. Retina

12. Suk KK, Flynn HW. Management options for submacular perfluorocarbon liquid. Ophthalmic Surg Las Im

13. Nowilaty SR. Ten-year follow-up of retained subfoveal perfluoro-N-octane liquid. Retin Cases Br Rep 2007; 1:41–43.

14. Lai JC, Postel EA, McCuen BW. Recovery of visual function after removal of chronic subfoveal perfluorocarbon liquid. Retina 2003;23:868–870.

15. Lesnoni G, Rossi T, Gelso A. Subfoveal liquid perfluorocarbon. Retina 2004;24:172–176.

16. Tewari A, Eliott D, Singh CN, Garcia-Valenzuela E, Ito Y, Abrams GW. Changes in retinal sensitivity from retained subretinal perfluorocarbon liquid. Retina 2009; 29:248– 250.

17. Berglin L, Ren J, Algvere PV. Retinal detachment and degeneration in response to subretinal perfluorodecalin
in rabbit eyes. Graefe’s Arch Clin Exp Ophthalmol1993;231:233–237.