Pharmacological Adjuncts to Vitrectomy Surgery

Savastano, Maria Cristina; Savastano, Alfonso; Rizzo, Stanislao

doi:10.2174/1381612825666190130125136

Cited by 3 publications

(1 citation statement)

References 105 publications

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“…Thus, all the adjuncts used in the four cases of injection jet-related IRBs noted by us are generally considered to be safe. [ 10 ] Thus, rather than the adjunct, we believe that it was the surgical technique that was responsible for the IRB. Retinal breaks and retinal detachment are highly uncommon after intravitreal injections in vitreous-filled eyes, and the frequency is said to be less than 0.1%.…”

Section: Discussionmentioning

confidence: 99%

Jet stream related iatrogenic retinal breaks during vitreo-retinal surgery

Takkar

Belenje

Agarwal

et al. 2022

Indian Journal of Ophthalmology

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Purpose: To evaluate the causes of jet stream injury (JSI)-related iatrogenic retinal breaks (IRBs) during vitreoretinal surgery (VRS). Methods: The precise surgical environment, which includes the indication and type of surgical procedure, retina status, details of instrumentation and fluidic parameters, and characteristics of the jet responsible for the IRB, was noted from case records. The nature of IRB and its healing and impact on anatomical and visual outcomes were analyzed. Results: Five eyes of five patients with complete documentation of both the JSI and the IRB were included. Two cases were operated for macular hole, and one each for vitreous hemorrhage, retinal detachment, and endophthalmitis. One case had infusion-fluid-related JSI, while four developed it because of injection of surgical adjuncts (drugs, PFCL, and dye). JSI developed in two cases when the vitreous cavity was filled with fluid, while it was air-filled in three cases. In four cases, the fluid migrated into subretinal space, necessitating further maneuvers following which the breaks healed, but were directly responsible for vision loss in two cases. Conclusion: JSI related IRBs are rare but may be directly responsible for vision loss if they impact the macula. The balance between jet stream velocity, its distance from the retinal surface, the intervening media (vitreous cavity), and retinal health play an important role. It can occur because of both infusion as well as injection jets. Precautions must be taken in cases vulnerable to complications with suggested modifications in the surgical technique.

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Section: Discussionmentioning

confidence: 99%

Jet stream related iatrogenic retinal breaks during vitreo-retinal surgery

Takkar

Belenje

Agarwal

et al. 2022

Indian Journal of Ophthalmology

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2019 Update in Retinal Pharmacotherapies

Grzybowski

Schwartz

Kanclerz³

2019

CPD

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Pharmacological adjuvants for diabetic vitrectomy surgery

Venkatesh,

Jayadev,

Prabhu

et al. 2024

World J Methodol

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Diabetic vitrectomy is a highly intricate surgical procedure performed during the advanced stages of diabetic retinopathy (DR). It is used to treat conditions such as tractional or combined retinal detachment, vitreous hemorrhage, and subhyaloid hemorrhage, which are all severe manifestations of proliferative DR. The results of the surgery are uncertain and variable. Vitreoretinal surgery has made significant progress since the early stages of vitrectomy. In the past ten years, advancements in intravitreal pharmacotherapy have emerged, offering new possibilities to improve the surgical results for our patients. Within the realm of medical terminology, an "adjunct" refers to a pharmaceutical or substance employed to aid or expedite the primary therapeutic intervention for a particular ailment. Their introduction has broadened the range of therapeutic choices that are accessible prior to, during, and following surgical procedures. This review article will specifically analyze the pharmacological adjuncts used in diabetic vitrectomy surgery, with a focus on their role in facilitating or aiding specific steps of the procedure. The implementation of this system of categorization offers benefits to the surgeon by allowing them to foresee potential difficulties that may occur during the surgical procedure and to choose the appropriate pharmacological agent to effectively tackle these challenges, thus enhancing surgical success rates.

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Pharmacological Adjuncts to Vitrectomy Surgery

Cited by 3 publications

References 105 publications

Jet stream related iatrogenic retinal breaks during vitreo-retinal surgery

Jet stream related iatrogenic retinal breaks during vitreo-retinal surgery

2019 Update in Retinal Pharmacotherapies

Pharmacological adjuvants for diabetic vitrectomy surgery

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