Mechanisms of Retinal Displacement After PFCL Assisted Rhegmatogenous Retinal Detachment Repair

Perfluorocarbon liquid (PFCL) assisted pars plana vitrectomy (PPV) is frequently used in reattachment surgeries for rhegmatogenous retinal detachment (RRD). This surgery can lead to postoperative retinal displacement, adversely affecting visual outcomes. We develop a comprehensive 3D computational model to elucidate the mechanics of PFCL-assisted reattachment, emphasising the role of PFCL density on retinal deformation by displacing the subretinal fluid (SRF). Results show that the density of PFCL critically governs contact pressure, SRF redistribution, and the extent of residual retinal displacement. Denser PFCLs yield greater mechanical loading and macular deformation up to 250 μm compared to lighter PFCLs, which maintain reattachment with reduced residual displacement. Apart from the density of PFCL, our simulations show that the location and size of holes or tears significantly influence retinal displacement. The simulations replicate clinical observations of retinal displacement, aligning with fluid flow direction. These findings offer a physics-based rationale for optimising PFCL selection to minimise retinal displacement, further inform surgical strategies, and improve anatomic integrity post-surgery.