# Surgical Technique: Viscodissection for Managing Funnel Retinal Detachments

## TL;DR

This paper introduces viscodissection as a new surgical technique to safely manage complex funnel-shaped retinal detachments, improving outcomes and reducing trauma.

## Contribution

The novel contribution is the use of viscodissection to safely open funnel-shaped retinal detachments and facilitate PFCL application.

## Key findings

- Viscodissection successfully enabled funnel opening and PFCL use in all five cases.
- Postoperative visual acuities improved in four patients, though one remained at hand motion.
- No retinal detachment recurrences occurred, but three patients needed reoperation for new PVR.

## Abstract

Purpose: To evaluate and describe the efficacy and safety of viscodissection in managing complex funnel-shaped retinal detachments, minimizing trauma and facilitating safer perfluorocarbon liquid (PFCL) application. Methods: A retrospective case series of five patients with funnel-shaped retinal detachments: three due to perforating trauma and two from recurrent detachments. Initial visual acuities ranged from light perception to hand motion. Viscodissection was used to separate adhered retinal tissues in the funnel-shaped retinal detachment in a controlled, minimally traumatic manner, allowing funnel opening and PFCL application. Data collected included demographics, visual acuities, surgical details, and complications. Results: Viscodissection enabled successful funnel opening and PFCL use in all cases, with one instance of subretinal migration of PFCL. No retinal detachment recurrences occurred, but three patients required reoperation for new premacular proliferative vitreoretinopathy (PVR). Postoperative visual acuities improved in four patients (up to 20/100), while one remained at hand motion. Conclusions: Viscodissection is a promising technique for complex funnel-shaped retinal detachments, allowing non-traumatic tissue separation and improving visualization and safety during PFCL application. This approach may enhance surgical outcomes and reduce complications.