Use of an intraocular gas tamponade to find retinal breaks.

We used the receding meniscus of an intraocular bubble being absorbed or the advancing meniscus of an expanding bubble to find the levels of retinal breaks in five patients with retinal detachments in which the breaks could not be found by the usual examination techniques. When we used a receding meniscus, the subretinal fluid was drained and the volume replaced by a perfluorocarbon gas calculated to fill the eye below the probable level of the retinal break. The bubble closed the break and maintained reattachment until the gas was absorbed. The level of the meniscus when redetachment first occurred indicated the level of the break. When we used an advancing meniscus, small amounts of perfluorocarbons were injected without drainage of subretinal fluid. As the gas bubble expanded it reattached the retina from above downward. When the bubble covered the retinal break, it tamponaded it and the remaining fluid absorbed within hours. The level of the meniscus when the retina became reattached marked the level of the retinal break.