Posterior-Segment Surgeries with a Two-Port Modified Multiport Illumination System

Abstract

Purpose: The purpose of this study was to evaluate the safety and efficacy of a modified two-port multiport illumination system (MIS) in different vitreoretinal surgeries. Patients and Methods: Sixty-one patients had undergone pars plana vitrectomy for complications of retinal diseases with the modified MIS. Only two-port pars plana vitrectomy was performed with the MIS. Visual acuity, intraoperative and postoperative complications, intraocular pressure and the retinal reattachment rate were evaluated. The mean follow-up time was 3 months (range 1–6 months). Results: Visual acuity was stabilized in 40 (65.5%) of 61 eyes, improved in 15 eyes (24.5%) and deteriorated in 6 eyes (9.8%). No intraoperative complications occurred. Postoperative complications were hypotony in 12 eyes, rehemorrhage in 2 eyes and choroidal detachment in 1 eye. Five cases required conversion to standard three-port vitrectomy. Mean overall preoperative and postoperative intraocular pressures were 17.4 and 11.9 mm Hg, respectively. Conclusion: Despite some limitations the modified MIS with two-port sclerotomy is a good, comfortable and safe option for posterior-segment surgeries.

Two-Port “Dry Vitrectomy” as a New Surgical Technique for Rhegmatogenous Retinal Detachment: Focus on Macula-on Results

“…Compared with the other mini-invasive vitrectomy procedures [ 23 , 24 , 25 , 26 , 27 ], the innovation of our two-port-minimally invasive vitrectomy is to remove the vitreous surrounding the retinal breaks without infusion and vitreal hydration. Consequentially, we preserve the vitreal gel with its structure and antioxidant properties to reduce the onset of post-operative inflammation, and simultaneously, we create a space for the gas to expand, reducing secondary tractions on other areas of the retina.…”

“…The first experiences of less invasive variants of classical vitrectomy were based on the use of two transconjunctival ports (“two-port vitrectomy”), with the aid of a slit lamp as a lighting system [ 24 ] or by means of infusion cannulas combined with probes of endoillumination [ 25 , 26 ].…”

One-port pars plana vitrectomy (by 25-G micro-incision)

“…The term "minimal invasive vitreous surgery" should also take into account the number of sclerotomies [4][5][6]. The fewer and smaller the transconjunctival pars plana sclerotomies are, the less inflammation/infection and the fewer entry site retinal break/s (and retinal detachment/s) [20] are expected to occur.…”

“…Recently, Er et al have published the "two-port modified multiport illumination system" technique [5]. To accommodate the illuminated tubes with the infusion line.…”

“…Lately, there has been a growing interest among vitreoretinal surgeons in trying to accomplish their tasks in the least invasive way [4][5][6][7][8][9][10][11][12][13]. It seems that carrying out vitreous surgery with a minimum number of [4][5][6] and very small sclerotomies [6][7][8][9]13], and vitrectomizing as little as possible [10], if not at all [11][12][13], would be the ideal way to make it faster, less traumatic and safer compared to the conventional TPPPV. In the light of this trend, a pilot, prospective, interventional study of an alternative "minimal invasive vitrectomy" carried out through only "one-port pars plana sclerotomy" for selected vitreous, macula and vitreomacular disorders was undertaken.…”