Vitreous Hydro-dissection with a Flute Needle for Inducing Posterior Vitreous Detachment in Pediatric Retinopathies

Retina. 2024 Oct 29. doi: 10.1097/IAE.0000000000004325. Online ahead of print.

Abstract

Purpose: To present a novel intraoperative technique using a flute needle to induce posterior vitreous detachment (PVD) in pediatric retinal cases.

Methods: Following 23-gauge pars plana vitrectomy in pediatric eyes with complex vitreoretinal disease, triamcinolone is applied for staining, and vitreous hydro-dissection is performed. A flute needle containing basic salt solution (BSS) is introduced to separate the thin residual posterior vitreous cortex from the retina near the vascular arcades. Gentle taps allow balanced salt solution (BSS) to enter the vitreous crevice, with controlled oscillation facilitating separation. PVD is then induced, and the vitrector is used to lift and complete the detachment.

Results: Vitreous hydro-dissection with a flute needle was effective in inducing PVD in pediatric eyes with complex vitreoretinal disease. We report no intraoperative or postoperative complications.

Conclusion: This adjuvant vitreous hydro-dissection technique facilitates PVD induction and may reduce the associated risk of iatrogenic retinal damage.