Short-term results of endovascular surgery with tissue plasminogen activator injection for central retinal vein occlusion

Ishida, M.; Abe, Shinya; Nakagawa, Takuya; Hayashi, Atsushi

doi:10.1007/s00417-017-3763-1

Cited by 3 publications

(3 citation statements)

References 24 publications

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“…For example, manual cannulation of the central retinal vein has been achieved during vitrectomy. 31,32 It is technically challenging and the time of infusion is limited, which is probably why it has not been widely adopted as part of the treatment of central retinal vein occlusion. De Smet et al demonstrated that retinal vein cannulation and infusion in pig eyes was possible for up to 20 min using the PSS, an achievement unimaginable without robotics.…”

Section: Discussionmentioning

confidence: 99%

“…Surgeries that are nearly impossible with manual surgery could be realised with robotic assistance. For example, manual cannulation of the central retinal vein has been achieved during vitrectomy 31,32 . It is technically challenging and the time of infusion is limited, which is probably why it has not been widely adopted as part of the treatment of central retinal vein occlusion.…”

Section: Discussionmentioning

confidence: 99%

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Randomised controlled trial on robot‐assisted versus manual surgery for pucker peeling

Faridpooya

Romunde

Manning

et al. 2022

Clinical Exper Ophthalmology

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Background The aim was to explore the feasibility and safety of performing common surgical steps in epiretinal membrane (ERM) peeling using the Preceyes Surgical System (PSS). Methods In a tertiary centre, 15 pseudophakic patients with an idiopathic ERM were randomised to robot‐assistance or manual surgery in a 2:1 ratio. In the robot‐assisted group, the following steps were performed using PSS: (1) staining the internal limiting membrane (ILM), (2) removal of the dye, (3) creating an ILM flap, (4) completing the peeling, (5) holding a light pipe and (6) fluid–air exchange. Primary outcome measures were feasibility and safety. Secondary outcome measures were duration, best‐corrected visual acuity (BCVA) and central retinal thickness (CRT). Moreover, the distance travelled by the instrument during peeling was assessed using motion tracking software. Results All steps performed with PSS were feasible with no clinical adverse events or complications. The surgical time was longer in the robot‐assisted group (mean 56 min, SD = 12 vs. 24 min, SD = 5). During the study, the duration of robot‐assisted surgeries decreased from 72 to 46 min. The distance travelled by the forceps was shorter in the robot‐assisted group (mean 403 mm, SD = 186 vs. 550 mm, SD = 134). BCVA and CRT improved equally in both groups. Conclusions This is the world's first randomised controlled trial on robotic surgery for ERM. Although more time‐consuming, we found that several surgical steps were feasible with assistance of the PSS.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Randomised controlled trial on robot‐assisted versus manual surgery for pucker peeling

Faridpooya

Romunde

Manning

et al. 2022

Clinical Exper Ophthalmology

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“…We and others have shown that retinal endovascular surgery with injection of a tissue plasminogen activating factor (tPA) into the retinal vein for central retinal vein occlusion was effective at improving visual acuity [ 2 , 3 ]. Recently, intraretinal arterial cannulation for CRAO was shown to significantly improve visual acuity from −1.6 to −0.82 logMAR at 1 month [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Retinal Endovascular Surgery with Tissue Plasminogen Activator Injection for Central Retinal Artery Occlusion

Takata

Nitta

Miyakoshi

et al. 2018

Case Rep Ophthalmol

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Purpose: To report 2 cases of central retinal artery occlusion (CRAO) who underwent retinal endovascular surgery with injection of tissue plasminogen activator (tPA) into the retinal artery and showed a remarkable improvement in visual acuity and retinal circulation. Methods: Standard 25-G vitrectomy was performed under local anesthesia. Simultaneously, tPA (80,000 units/mL) solution was injected into the retinal artery of the optic disc for 2–3 min using a microneedle. Changes in visual acuity, fundus photography, optical coherence tomography (OCT), fluorescein angiography, and laser speckle flowgraphy (LSFG) results were examined. Results: Both cases could be treated within 12 h after the onset of CRAO. Case 1 was a 47-year-old woman. Her visual acuity improved from counting fingers before operation to 0.08 logMAR 1 month after the surgery. However, thinning of the retina at the macula was observed by OCT. Case 2 was a 70-year-old man. His visual acuity improved from counting fingers to 0.1 logMAR 2 months after the surgery. Both fluorescein angiography and LSFG showed improvement in retinal circulation after the surgery in case 2. Conclusions: Retinal endovascular surgery with injection of tPA into the retinal artery was feasible and may be a way to improve visual acuity and retinal circulation when performed in the acute phase of CRAO.

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Endovascular surgery in the field of ophthalmology

2020

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Short-term results of endovascular surgery with tissue plasminogen activator injection for central retinal vein occlusion

Abstract: REVS using a specially made micro-needle may be a surgical treatment option for non-ischemic CRVO, but it did not seem effective for ischemic CRVO.

Cited by 3 publications

References 24 publications

Randomised controlled trial on robot‐assisted versus manual surgery for pucker peeling

Randomised controlled trial on robot‐assisted versus manual surgery for pucker peeling

Retinal Endovascular Surgery with Tissue Plasminogen Activator Injection for Central Retinal Artery Occlusion

Endovascular surgery in the field of ophthalmology

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