Paediatric RD - PVR: PFCL for PVD-Use & Limitations

Watch PFCL turn an impossible PVD into a controlled, elegant manoeuvre (Technique courtesy Dr Vishal Agarwal).
PVD induction in children and young adults is never straightforward. The posterior hyaloid is tenacious, the retina is vulnerable, and every manoeuvre demands precision. In this video, we explore how PFCL can be used as a powerful adjunct to safely and effectively induce a PVD in these challenging eyes.

This case features a 14‑year‑old boy with an inferior retinal detachment and PVR following blunt trauma, presenting with a vision of 6/60. After a standard 25‑gauge three‑port vitrectomy, triamcinolone was used to highlight the posterior hyaloid, allowing initial separation at the disc with active suction.

Once a small pocket opened, a PFCL bubble was gently injected beneath the detached hyaloid, and progressively expanded to extend the PVD toward the periphery while simultaneously stabilizing the posterior pole. This stability offers a major advantage — safer, easier peripheral vitrectomy.

But PFCL comes with its own limitation: thin, immature pre‑retinal membranes are harder to peel under PFCL, so membrane work has to be completed after PFCL removal.

After complete traction relief, the surgery concluded with fluid–air exchange, endolaser, and 15% C3F8 gas tamponade. At two months, the retina was attached and vision improved to 6/18.

Watch as we break down the technique, its advantages, its limitations, and the subtle decisions that make PFCL‑assisted PVD induction a valuable tool in young eyes.

PFCL‑assisted PVD induction

Posterior hyaloid separation technique

Paediatric retinal detachment surgery

Young adult PVD induction

Traumatic retinal detachment

Inferior RD with PVR

25G pars plana vitrectomy

Triamcinolone‑assisted PVD

PFCL bubble technique

Peripheral vitrectomy under PFCL

Pre‑retinal membrane peeling challenges

C3F8 gas tamponade

Retinal detachment in children

Vitreoretinal surgery teaching case

Retina surgical techniques 2026

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Видео Paediatric RD - PVR: PFCL for PVD-Use & Limitations канала Retinal Surgery Simplified