Operating Microscope-Induced Retinal Phototoxicity During Pars Plana Vitrectomy

Results of macular pucker surgery: 1- and 5-year follow-up

“…These patients had not needed a fluid-air exchange during surgery [21]. Nor do we think that phototoxicity was the cause, as we have not noticed RPE changes in the macula in these patients [14,15,19]. This scotoma may be caused, however, by damage to the superficial capillaries or nerve-fiber layer by the removal of the epiretinal membrane, as described by Green on histology [7].…”

Morphological changes in the optic disc after vitrectomy and fluid–air exchange

“…Many investigators have reported various ocular complications induced by vitrectomy, including corneal damage [10,12], retinal damage due to the composition of the irrigation solution [2,13], and nerve fiber damage induced by the light toxicity of endoillumination [9,11]. However, little is known about post-operative complications in the optic disc.…”

“…There was no significant difference in intraocular pressure among any of the patient groups either pre-or post-operatively Table 2 Pre-and post-operative HRT parameters. There was no significant difference in HRT parameters among any of the patient groups pre-operatively (11)(12)(13)(14)(15)(16)(17)(18) coemulsification and posterior chamber intraocular lens implantation were involved in all of the patients with the exception of two that had already undergone cataract surgery elsewhere. Following a pars plana vitrectomy, the adherent posterior cortical vitreous was engaged using a vitreous cutter with active aspiration in every case but one, in which PVD was already apparent pre-operatively (Table 2).…”

“…Some previous reports, however, have indicated that complications were induced by vitrectomy, including corneal damage [10,12], retinal damage due to the composition of the irrigation solution [2,13], postoperative visual field loss [4,6,8] and nerve fiber damage induced by light toxicity from endoillumination [9,11]. Additionally, although surgical induction of posterior vitreous detachment (PVD) and fluid-air (F-A) exchange are indispensable techniques in modern vitrectomy, these procedures were also reported to cause retinal damage [4,6,8,14].…”

Lightless cataract surgery using a near-infrared operating microscope

“…However, the light from the microscope can induce retinal pathology, so-called phototoxic retinopathy. [5][6][7][8][9][10][11][12][13][14] The risk for developing phototoxic retinopathy increases with wavelengths between 400 nm and 500 nm, and the most hazardous wavelength ranges from 435 to 440 nm. 15,16 The surgical microscope emits light in the electromagnetic range between 400 nm and 500 nm.…”