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목적 : To estimate the pressure distribution on retina and vitreous cavity during air-fluid exchange in air-filled eye
방법 : A computer simulation was conducted using three-dimensional modeling software. We simulated the fluid dynamics of air-fluid exchange in an air-filled eye. A fixed grid finite element, based on volume of fluid model, and pressure-based coupled algorithm, were used to analyze fluid dynamics. Infusion port size and infusion pressure were altered for each simulated iteration. Detailed pressure distribution of retina and vitreous cavity were recorded at intervals of 0.0001 second.
결과 : Pressurized fluid flowed straightly into vitreous cavity from the infusion port. Pressure of air in vitreous cavity quickly equilibrated with atmosphere (0 mmHg) through the exhaust port. Peak pressure was observed at a point on the part of retina contralateral to the infusion port (vulnerable point). Temporary pressure increases were observed at initial collision. With a 20-gauge system, pressures at the vulnerable point were 62.6, 130.2 and 184.2 mmHg at infusion pressures of 20, 40, and 60 mmHg, respectively. In 23- and 25-gauge, the peak pressures were higher than the infusion pressure.
결론 : Pressurized fluid infusion can generate high pressure at vulnerable point of retina during air-fluid exchange in air-filled eye. Performing air-fluid exchange with low infusion pressure and small gauge vitrectomy system could prevent retinal damage from pressurized fluid infusion.
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