Ultrasound Biomicroscopy of Sclerotomy Sites

Sabti, Khalid Al; Kapusta, Michael A.; Mansour, Magdi; Overbury, Olga; Chow, David R.

doi:10.1097/00006982-200110000-00008

Cited by 38 publications

(11 citation statements)

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“…The residual vitreous strand surrounding the cannula can clog the ports and can lead to increased rates of complications such as fibrovascular proliferation, recurrent vitreous hemorrhage and retinal breaks leading to detachment [17]. Therefore, many studies were undertaken to determine the effect of the scleral incision shape on the complication rate.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the 20-Gauge Conventional Vitrectomy Technique with the 23-Gauge Releasable Suture Vitrectomy Technique

Kim

Lee

Park

2013

Korean J Ophthalmol

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PurposeTo compare the efficacy of the transconjunctival releasable suture technique for pars plana vitrectomy using 23-gauge (23G) instruments versus the conventional 20-gauge (20G) technique.MethodsA retrospective and interventional case series was consecutively performed for 199 eyes of the 192 patients that were a part of this study. Clinical data were reviewed retrospectively regarding the operation time, preoperative and postoperative intraocular pressure, visual acuity and astigmatism for 54 consecutive patients who received a 23G releasable suture vitrectomy and for 98 consecutive patients who received a 20G conventional vitrectomy during the period between April 2007 and September 2010.ResultsMean operation time based on the operation record was 88.5 ± 20.1 minutes in the 23G releasable suture vitrectomy group and 102.1 ± 23.1 minutes in the 20G conventional vitrectomy group, respectively (p = 0.01). The last best-corrected visual acuity (BCVA) was significantly better than the preoperative BCVA in both patient groups (p = 0.01, p = 0.01). The 23G releasable suture group showed less surgically induced astigmatism than the 20G conventional vitrectomy group. Vitreous bleeding was observed to be in 6 eyes (5.9%) in the 23G group, and in 8 eyes (8.2%) in the 20G group. In addition, ocular hypertension was noted to be in 3 eyes (3.0%) in the 23G group, and 6 eyes (6.1%) in the 20G group. No serious complications such as postoperative hypotony or endophthalmitis were observed in either group.ConclusionsThe 23G releasable suture technique is as effective as the 20G conventional technique and offers several advantages.

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Section: Discussionmentioning

confidence: 99%

Comparison of the 20-Gauge Conventional Vitrectomy Technique with the 23-Gauge Releasable Suture Vitrectomy Technique

Kim

Lee

Park

2013

Korean J Ophthalmol

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“…It would be much more difficult to observe these areas in case of vitreous hemorrhage, vitreous opacity, or opaque vitreous skirt [6]. Although ultrasound biomicroscopy (UBM) have been used for detecting the inner aspect of sclerotomy sites before surgery [12, 13], by which the degree of vitreous incarceration could be graded indirectly [13, 14]. However, UBM could not identify different tissues incarcerated in sclerotomy sites due to the same echo of retina and vitreous.…”

Section: Discussionmentioning

confidence: 99%

Vitreous Incarceration in Patients Undergoing Second 20-Gauge Pars Plana Vitrectomy for Recurrent Retinal Detachment

et al. 2011

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Purpose. To observe and classify vitreous incarcerations in patients undergoing second 20-gauge pars plana vitrectomy (PPV) for recurrent retinal detachment. Methods. Retrospective noncomparative consecutive case series. Eighty-two consecutive patients with recurrent retinal detachment were included. The previous sclerotomy sites were examined by our sclera depression method and the vitreous incarceration were classified into Grade 0–IV by their severity under surgical microscope before second surgery. The relationship of vitreous incarceration and different ports was statistically investigated in our included patients. Results. Vitreous incarceration in the previous sclerotomy sites were found frequently. Vitreous cutter sites were most involved, but the infusion pipe sites were the least. According to our classification and definition, Grade III and IV of vitreous incarceration in all the three different sclerotomy sites accounted for 32.5%. Grade II of vitreous incarceration consisted of 12.6%. Grade 0 and I in all the three different sclerotomy sites were 54.8%. The frequency of all grades of vitreous incarceration in light port or vitreous cutter port was significant higher than that in infusion port. Conclusions. Vitreous incarceration in light port and vitreous cutter port are found more common than in infusion port for 20-gauge PPV with our new method.

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“…Vitreous shaving around sclerotomy sites has been found to reduce vitreous incarceration following pars plana vitrectomy. 10 A study in patients evaluating the sclerotomy site endoscopically through another cannula in 32 eyes that underwent 23-gauge non-valved cannula vitrectomy found no vitreous incarceration in 30 eyes (94%) when one cannula was removed with insertion of a light probe, with only minimal vitreous incarceration observed in the other two eyes. 11 Experimental models in porcine cadaver eyes showed that interposing a light probe through the cannula during its removal reduced the rate and severity of vitreous incarceration.…”

Section: Introductionmentioning

confidence: 99%

Globe stability during simulated vitrectomy with valved and non-valved trocar cannulas

Abulon¹,

Charles²,

Charles³

2015

OPTH

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PurposeTo compare the effects of valved and non-valved cannulas on intraocular pressure (IOP), fluid leakage, and vitreous incarceration during simulated vitrectomy.MethodsThree-port pars plana incisions were generated in six rubber eyes using 23-, 25-, and 27-gauge valved and non-valved trocar cannulas. The models were filled with air and IOP was measured. Similar procedures were followed for 36 acrylic eyes filled with saline solution. Vitreous incarceration was analyzed in eleven rabbit and twelve porcine cadaver eyes.ResultsIn the air-filled model, IOP loss was 89%–94% when two non-valved cannulas were unoccupied versus 1%–5% when two valved cannulas were unoccupied. In the fluid-filled model, with non-valved cannulas, IOP dropped while fluid leaked from the open ports. With two open ports, the IOP dropped to 20%–30% of set infusion pressure, regardless of infusion pressure and IOP compensation. The IOP was maintained in valved cannulas when one or two ports were left open, regardless of IOP compensation settings. There was no or minimal fluid leakage through open ports at any infusion pressure. Direct microscopic analysis of rabbit eyes showed that vitreous incarceration was significantly greater with 23-gauge non-valved than valved cannulas (P<0.005), and endoscopy of porcine eyes showed that vitreous incarceration was significantly greater with 23-gauge (P<0.05) and 27-gauge (P<0.05) non-valved cannulas. External observation of rabbit eyes showed vitreous prolapse through non-valved, but not valved, cannulas.ConclusionValved cannulas surpassed non-valved cannulas in maintaining IOP, preventing fluid leakage, and reducing vitreous incarceration during simulated vitrectomy.

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Ultrasound Biomicroscopy of Sclerotomy Sites

Abstract: Vitreous shaving of sclerotomy sites using depressed vitrectomy significantly reduces vitreous incarceration. This may reduce the rate of sclerotomy-related complications following PPV in selected cases.

Cited by 38 publications

References 11 publications

Comparison of the 20-Gauge Conventional Vitrectomy Technique with the 23-Gauge Releasable Suture Vitrectomy Technique

Comparison of the 20-Gauge Conventional Vitrectomy Technique with the 23-Gauge Releasable Suture Vitrectomy Technique

Vitreous Incarceration in Patients Undergoing Second 20-Gauge Pars Plana Vitrectomy for Recurrent Retinal Detachment

Globe stability during simulated vitrectomy with valved and non-valved trocar cannulas

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Ultrasound Biomicroscopy of Sclerotomy Sites

Abstract: Vitreous shaving of sclerotomy sites using depressed vitrectomy significantly reduces vitreous incarceration. This may reduce the rate of sclerotomy-related complications following PPV in selected cases.

Cited by 38 publications

References 11 publications

Comparison of the 20-Gauge Conventional Vitrectomy Technique with the 23-Gauge Releasable Suture Vitrectomy Technique

Comparison of the 20-Gauge Conventional Vitrectomy Technique with the 23-Gauge Releasable Suture Vitrectomy Technique

Vitreous Incarceration in Patients Undergoing Second 20-Gauge Pars Plana Vitrectomy for Recurrent Retinal Detachment

Globe stability during simulated vitrectomy with&nbsp;valved and non-valved trocar cannulas

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Globe stability during simulated vitrectomy with valved and non-valved trocar cannulas