Fully Automated Direct Perfluorocarbon Liquid-Silicone Oil Exchange

PURPOSE: To demonstrate a modified technique of fully automated direct perfluorocarbon liquid (PFCL)-silicone oil (SO) exchange. MATERIALS AND METHODS: This technique is indicated for cases that require direct PFCL-SO exchange as in giant retinal tear or large retinectomies to avoid retinal slippage. Pars plana vitrectomy (PPV) is carried out in standard fashion; then the dual active injection/extrusion mode is activated in the vitrectomy machine. The machine parameters are set at approximately 30–40 psi for SO injection and 150–250 mmHg for active PFCL aspiration. In this method, both the SO injection and the PFCL extrusion are simultaneously controlled by the foot pedal. RESULTS: We used this technique for a total of 24 cases: 6 cases of giant retinal tears and 18 retinectomies. We did not encounter any complications related to significant IOP spike during surgery or complete removal of the PFCL. CONCLUSION: This automated technique for direct PFCL-SO exchange maintains a controlled balance between SO injection and PFCL aspiration, that mitigates the risk of intraoperative IOP spikes. It is safe, quick, and can be performed without the need of an assistant or extra chandelier light or high-pressure viscous tubing.