Anatomical and Functional Outcomes of Internal Limiting Membrane Flap-Assisted Removal of Retained Subretinal Perfluorocarbon Liquid: A Case Series of Three Patients

Background: Retained subretinal perfluorocarbon liquid (PFCL) is a potentially vision-threatening complication of retinal detachment surgery. No standardized surgical approach exists. This study describes an internal limiting membrane (ILM) flap-assisted removal technique. Methods: Three symptomatic patients underwent 23-gauge pars plana vitrectomy for retained subretinal PFCL, subfoveal in one eye and parafoveal in two. A temporally hinged ILM flap was reflected and stabilized with an intravitreal PFCL bubble, and 39-gauge cannulas were used for focal transretinal puncture and subsequent aspiration of the retained PFCL. The flap was repositioned using a new PFCL bubble, followed by fluid–air exchange. Outcomes were assessed using optical coherence tomography (OCT), best-corrected visual acuity (BCVA), and patient-reported visual symptoms over 8–33 months. Results: Complete PFCL removal was achieved in all cases. Final BCVA was better than immediately before PFCL removal in all eyes. OCT demonstrated variable structural recovery, with varying degrees of residual structural abnormalities. No epiretinal membrane (ERM) formation was detected during follow-up. Conclusions: The technique enabled complete PFCL removal in three selected patients. Given the small sample, case heterogeneity, and potential confounding effects of previous retinal detachment and concomitant procedures, the findings support technical feasibility but do not establish efficacy, safety, or superiority over existing approaches.