Air Bubble Technique for Fundus Visualization during Vitrectomy in Aphakia

Abstract

Purpose To evaluate the efficacy and safety of air bubble technique for vitrectomy in aphakia. Study Design Prospective interventional uncontrolled case series. Methods This study included 53 eyes of 53 patients who are phakic and indicated for phacovitrectomy (7 eyes, group 1), aphakic and indicated for vitrectomy (22 eyes, group 2), or underwent unplanned vitrectomy for immediate management of a phacoemulsification surgery complicated by rupture posterior capsule with dropped nucleus, fragments, or IOL (24 eyes, group 3). Cases with complicated vitreoretinal pathology were not included in this study. All vitrectomy surgeries were conducted by the air bubble technique in the anterior chamber. Main outcomes included anatomical success, visual acuity, and intraoperative and postoperative complications. Results The surgical success was achieved in 50 eyes (94.3%). Conversion to BIOM viewing system was needed in the retinal detachment cases of groups 1 and 2. The mean overall LogMAR visual acuity was significantly improved from 1.29 ± 0.58 preoperatively to 0.56 ± 0.19 at the final visit, 6 months postoperatively (P < 0.001). Conclusion The air bubble technique as visualization method for vitrectomy in aphakia is an effective and cheap technique for immediate management of complications of phacoemulsification surgery. This trial is registered with Pan African Clinical Trial Registry PACTR201709002466296.

Intraoperative fundus inspection during surgery

“…5 Air in the anterior chamber is used to help seal surgical wounds and has been shown to prevent inflow of ocular surface fluid into the eye. 6 Fundus visualization during vitrectomy only in aphakia using the air bubble technique had been earlier described as an alternative to vitrectomy lenses, 7,8 and it was reported to be safe and cost-effective. 8 However, visualization of the retina using an air bubble is limited and not even close to the quality of direct or indirect ophthalmoscopy using artificial lens systems.…”

“…6 Fundus visualization during vitrectomy only in aphakia using the air bubble technique had been earlier described as an alternative to vitrectomy lenses, 7,8 and it was reported to be safe and cost-effective. 8 However, visualization of the retina using an air bubble is limited and not even close to the quality of direct or indirect ophthalmoscopy using artificial lens systems. We definitely do not recommend using this technique for surgical manoeuvres.…”