A Novel Method of Draining Intraoperative Choroidal Detachments During 23-Gauge Pars Plana Vitrectomy

Witkin, André J.; Fineman, Mitchell S.; Ho, Allen C.; Spirn, Marc J.

doi:10.1001/archophthalmol.2012.1472

Cited by 7 publications

(5 citation statements)

References 5 publications

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“…This technique is rapid and simple and can drain the suprachoroidal fluid intraoperatively, and it has several advantages over other drainage methods. 10,11 First, only one 27-gauge needle is inserted through the sclera in addition to the usual standard 3 ports. This means that there is no need for another sclerotomy or anterior chamber penetration for the infusion line.…”

Section: Discussionmentioning

confidence: 99%

New Technique to Drain Suprachoroidal Fluid With a 27-Gauge Needle During Vitrectomy

Iwase

Ra²,

Terasaki³

2022

Retina

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Section: Discussionmentioning

confidence: 99%

New Technique to Drain Suprachoroidal Fluid With a 27-Gauge Needle During Vitrectomy

Iwase

Ra²,

Terasaki³

2022

Retina

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“…In the past, many surgeons have described the use of vitrectomy instruments for SB, including chandelier lighting and wide-angle viewing systems on surgical microscopes [12,13]. Similarly, the development of new techniques to drain choroidal detachments, using trocars placed in the suprachoroidal space, have allowed surgeons to be more familiarized with this region of the posterior segment [14,15]. SCB uses techniques that are more familiar to vitrectomytrained surgeons, but many are still reticent to try it.…”

Section: Discussionmentioning

confidence: 99%

Hemorrhagic complications associated with suprachoroidal buckling

et al. 2020

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Background: Multiple surgical techniques exist for the repair of rhegmatogenous retinal detachments (RRD). Suprachoroidal buckling (SCB), consisting of injecting viscoelastic material in the suprachoroidal space to allow chorioretinal apposition, has been recently described in the repair of RRD. The aim of this study is to report the complications of SCB and to propose measures to decrease their incidence during the learning curve. Methods:A total of 26 eyes of 26 patients who underwent a SCB procedure for the management of RRD secondary to a single or multiple retinal breaks were enrolled. Patients were operated between January 2014 and March 2017 at two academic institutions. Patient and retinal detachment characteristics were obtained from the charts. Surgical videos were reviewed for every case and intraoperative complications were recorded. Complications observed postoperatively were obtained from the charts.Results: Sixteen eyes (62%) underwent SCB alone, 5 eyes (19%) underwent additional gas tamponade and 5 eyes (19%) had combined pars plana vitrectomy. The most common complication was hemorrhage (6 cases, 23%). There were no cases of ischemic choroidal changes or hyperpigmentation at the edge of the dome. All six complications occurred in phakic patients who had inferior RRD with retinal breaks in the inferior quadrants. Isolated subretinal hemorrhage occurred in 4 patients and isolated suprachoroidal hemorrhage in 1 patient, and those did not affect final visual outcome. Extensive combined subretinal and suprachoroidal hemorrhage occurred in one case, and was complicated by phthisis bulbi. Re-detachment occurred in 4/6 (67%) of patients, and 5/6 (83%) of patients required a secondary procedure. Three out of 6 patients (50%) had at least 2 lines of visual acuity improvement.Conclusion: SCB performed for RRD can be associated with hemorrhagic complications. The hemorrhages are usually self-limited but may occasionally result in severe visual compromise when involving the suprachoroidal space. Specific surgical measures need to be undertaken in order to decrease the likelihood of complications and further studies are needed to assess the safety and efficacy of this technique.

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“…If fluid does get under the choroid, close the infusion immediately, pull out the infusion line, and put it through another cannula and check its position before opening it. Or, in the case of a partially disinserted cannula, leave it in position and use it to drain the suprachoroidal fluid [12]. If no fluid flows or not all of fluid drains, pull out the cannula and enlarge the sclerotomy.…”

Section: Discussionmentioning

confidence: 99%

Surgical pearls: combined retinal detachment and choroidal detachment — can you insert an infusion cannula?

2019

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Combined retinal detachment and choroidal detachment is an uncommon diagnosis that a surgeon will occasionally face. Although the experienced vitreoretinal surgeon can manage nearly all obstacles during the surgery, an inexperienced vitreoretinal surgeon will face a few difficulties during certain steps. In this article, we describe a case report and highlight some of these obstacles and suggest some options to overcome them.

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A Novel Method of Draining Intraoperative Choroidal Detachments During 23-Gauge Pars Plana Vitrectomy

Cited by 7 publications

References 5 publications

New Technique to Drain Suprachoroidal Fluid With a 27-Gauge Needle During Vitrectomy

New Technique to Drain Suprachoroidal Fluid With a 27-Gauge Needle During Vitrectomy

Hemorrhagic complications associated with suprachoroidal buckling

Surgical pearls: combined retinal detachment and choroidal detachment — can you insert an infusion cannula?

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