The ex utero intrapartum treatment (EXIT) procedure is a very rare technique performed in cases of fetal congenital malformations. The EXIT procedure increases the rate of survival at delivery by maintaining the uteroplacental circulation until the airway of the fetus is secured. To maintain the uteroplacental circulation, a higher dose of inhalational anesthetics and/or intravenous nitroglycerin can be used as compared to conventional Cesarean section. The aim of this report is to share our anesthetic experience during the EXIT procedure with members of the Korean society of anesthesiology for the first time, and to highlight the maternal implications of the use of inhalational anesthetics and nitroglycerin during Cesarean section for the EXIT procedure.
Purpose: To report the clinical results of a planned vitrectomy, laser photocoagulation and gas tamponade for the treatment of serous macular detachment associated with optic disc pit. However, laser photocoagulation was performed on a postoperative outpatient basis for subretinal fluid. Case summary: A 13-year-old women presented with central visual disturbance in the left eye. Her best-corrected visual acuity (BCVA) was 0.16. On ophthalmic examination, the patient was diagnosed with optic disc pit combined with serous macular detachment. After 3 months, the serous macular detachment increased and visual acuity decreased to 0.1. Pars plana vitrectomy combined with complete posterior vitreous detachment was performed. After intravitreal injection of perfluorodecalin, internal drainage of the subretinal fluid using the back flush needle around the optic disc pit was performed, but the fluid was not drained. The planned intraoperative photocoagulation was not performed due to a large serous macular detachment. Gas tamponade was performed and a facedown position was maintained for 1 week followed by laser photocoagulation. The subretinal fluid was completely absorbed and visual acuity was improved. In addition, recurrence was not observed throughout the follow-up period. J Korean Ophthalmol Soc 2010;51(1):155-158
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