OBJECTIVE: To describe a series of cases of iatrogenic retinal breaks (IRBs) caused by the infusion fluid flow of a 25-gauge pars plana vitrectomy (PPV) system. DESIGN: Retrospective case series. METHODS: During 25-gauge PPV, 4 cases had IRBs caused by infusion fluid flow. The IRBs rapidly progressed to localized retinal detachment. RESULTS: The first 3 cases had IRBs on the nasal quadrant midperiphery of the retina. The IRBs were treated with laser retinopexy and tamponade during surgery. Case 4 had a macular hole and macular detachment during scleral indentation. The IRBs seemed to be caused by intraocular pressure (IOP) control mechanisms of the vitrectomy device. CONCLUSIONS: To prevent IRBs caused by infusion fluid flow, we recommend using an IOP control limit of 4 mL/min for 25-gauge vitrectomy, with valved cannulas. In addition, the surgeon must be cautious during scleral indentation and air-fluid exchange not to cause a rebound hypotonia.
OBJECTIVE: To describe a series of cases of iatrogenic retinal breaks (IRBs) caused by the infusion fluid flow of a 25-gauge pars plana vitrectomy (PPV) system. DESIGN: Retrospective case series. METHODS: During 25-gauge PPV, 4 cases had IRBs caused by infusion fluid flow. The IRBs rapidly progressed to localized retinal detachment. RESULTS: The first 3 cases had IRBs on the nasal quadrant midperiphery of the retina. The IRBs were treated with laser retinopexy and tamponade during surgery. Case 4 had a macular hole and macular detachment during scleral indentation. The IRBs seemed to be caused by intraocular pressure (IOP) control mechanisms of the vitrectomy device. CONCLUSIONS: To prevent IRBs caused by infusion fluid flow, we recommend using an IOP control limit of 4 mL/min for 25-gauge vitrectomy, with valved cannulas. In addition, the surgeon must be cautious during scleral indentation and air-fluid exchange not to cause a rebound hypotonia.