There exist occasions when an outpatient office fluid/ gas exchange is preferred over returning a patient to the operating room. These situations involve an aqueous filled eye that had previously undergone vitrectomy but now could benefit from the effects of an almost complete posterior segment gas fill. Common indications include recurrent vitreous hemorrhage, failed macular hole repair, and recurrent nontractional retinal detachment. Multiple techniques have been described in the last three decades to accomplish this goal. Without delving into an exhaustive history of the techniques, they can primarily be divided into the number of needles used (one vs. two) and head/body positioning. Each permutation has inherent advantages and disadvantages.
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