Paul A. Cibis, MD: a pioneer of modern vitreoretinal surgery.

Paul Anton Cibis (1911-1965) was one of the pioneers of modern vitreoretinal surgery. He reasoned that the pathology of complex retinal detachments was intravitreal fibrosis and concluded that the optimum surgery was the injection of liquid silicone oil into the vitreous cavity to dissect fibrous membranes from the retinal surface and use the silicone for retinal tamponade. Prior to the invention of pars plana vitrectomy, such surgery was innovative, even daring. These surgical techniques were an important advance in directly operating on the vitreous in retinal detachment surgery. However, Cibis' contributions to vitreoretinal surgery only occupied the last 10 years of his tragically short life. Prior to his practice in retinal surgery, he made contributions to basic research in physiologic optics, local retinal adaptation, and the effect of ionizing radiation and atomic energy on the globe.

[Perfluorocarbon liquids and vitreoretinal surgery in 2011]. / Perfluorocarbones liquides et chirurgie vitréo-rétinienne en 2011.

Perfluorocarbon liquids (PFCLs) are one of the most innovative recent tools for vitreoretinal surgery. PFCLs are characterized by their number of carbon atoms, which has an impact on the density, viscosity, surface tension, vapor pressure, the boiling point, and the refraction index. PFCLs are routinely used because of their high gravity (double that of water) and their low viscosity. Furthermore, they are immiscible in water, optically clear with refraction indices similar to that of water, allowing visualization of an interface between the PFCL and saline. The use of intravitreally injected liquid PFCLs as adjunctive agents to vitreoretinal surgery plays an important role in facilitating retinal reattachment, especially in cases of giant retinal tear, trauma, and/or proliferative vitreoretinopathy. PFCLs are also used as intraoperative instruments to re-establish intraocular volume, assist in separating membranes adherent to the retina (in proliferative diabetic retinopathy, for example), and manage the dislocated crystalline lens and intraocular lens.