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

Abulon, Dina Joy K.; Charles, Martin; Charles, Daniel E.

doi:10.2147/opth.s86326

Cited by 3 publications

(4 citation statements)

References 11 publications

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“… 21 – 23 The stable fluidics of valved cannulas offers a potential for decreased attraction of vitreous incarceration into the cannulas, which has been shown experimentally in the eyes of rabbit. 24 In our series, no case of vitreous incarceration at the cannula site was reported in either group, but it is possible that a larger series will elucidate a difference.…”

Section: Discussionmentioning

confidence: 60%

Valved versus nonvalved cannula small-gauge pars plana vitrectomy for repair of retinal detachments with Grade C proliferative vitreoretinopathy

Oellers

Stinnett

Hahn

2016

OPTH

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PurposeValved cannulas are a recent addition to small-gauge pars plana vitrectomy (PPV) and provide stable intraocular fluidics. The goal of this study was to compare outcomes and postoperative complication rates of valved vs nonvalved cannula small-gauge PPV for repair of retinal detachments (RDs) complicated by Grade C proliferative vitreoretinopathy (PVR).MethodsA retrospective chart review of 364 consecutive eyes with either valved or nonvalved cannula PPV for RD repair was performed. The primary outcomes were single surgery and final anatomic success and change in best-corrected visual acuity for repair of RDs complicated by Grade C PVR.ResultsWe identified 36 eyes in the valved group and 31 eyes in the nonvalved group with Grade C PVR RD. The single surgery success was 83% vs 77% (P=0.555) and the final anatomic success was 94% vs 87% (P=0.404) in the valved vs nonvalved eyes, respectively. The mean final visual acuity gain was −0.36 logarithm of the minimum angle of resolution (logMAR; approximate Early Treatment Diabetes Retinopathy Study [ETDRS] score =17 letters) in valved eyes vs −0.33 logMAR (approximate ETDRS score =16 letters) in nonvalved eyes (P=0.81). Postoperative complication rates including postoperative day 1 hypotony, hypertony, and anterior chamber fibrin formation; postoperative retention of intraocular or subretinal perfluorocarbon liquid; and subsequent epiretinal membrane peel were not statistically different between groups.ConclusionValved cannula PPV yields equivalent visual acuity and anatomic outcomes without increased postoperative complication rates compared to traditional nonvalved cannula PPV for Grade C PVR-associated RD repair.

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Section: Discussionmentioning

confidence: 60%

Valved versus nonvalved cannula small-gauge pars plana vitrectomy for repair of retinal detachments with Grade C proliferative vitreoretinopathy

Oellers

Stinnett

Hahn

2016

OPTH

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“…During vitrectomy, valved trocar cannulas were used to stabilize the intraocular volume 33 . Three-port, 23-gauge vitrectomy (Associate; Dutch Ophthalmic Research Center B.V., Zuidland, the Netherlands) was performed with an indirect BIOM lens (Oculus Biom Ready; Oculus Surgical, Inc., Port St. Lucie, FL, USA).…”

Section: Resultsmentioning

confidence: 99%

Ab-interno surgical technique for the implantation of a wireless subretinal prosthesis in mini-pigs

Choi

Anh

Seo

et al. 2020

Sci Rep

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We sought to describe the surgical techniques required in the ab-interno method to implant subretinal prostheses in mini-pigs and suggest tips to facilitate optimal outcomes. During vitrectomy, the use of valved trocar cannulas was essential to stabilize the detached retina and implanted chip. As a first step in retinal detachment, a 23-gauge cannula with very small amount of viscoelastic material was used to establish the retinal hole and promote retinal detachment. Then, balanced salt solution was applied to increase the retinal detachment and diathermy was used to make opening for subretinal prosthesis. For easy positioning of the subretinal prosthesis, a curved laser probe was adopted when handling the subretinal prosthesis under the retina. After surgery, the sclerotomy sites were tightly sutured to prevent silicone oil leakage. Without special equipment, such as a 41-gauge tip, retinal detachment could be induced easily, while the prosthesis was also successfully inserted and manipulated under the retina without an iatrogenic retinal tear. Two weeks after the operation, the oil fully occupied the intraocular volume without leakage. The subretinal prosthesis remained stable without complication. Understanding the principle of the ab-interno method and considering several tips for improving surgical access may help to enhance surgical success rates of subretinal prostheses implantation.

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“…However, fluid reflux through unobstructed trocars could have increased vitreous traction on the peripheral retina, leading to retinal breaks. [26][27][28] Wound closure was more complicated in the 25-gauge cases, which could account for the slightly increased surgical duration for these cases. The smaller lumina and light fibers, increased instrument flexibility, and smaller forceps platforms in 27-gauge vitrectomy did not extend the surgical duration over that of 25-gauge vitrectomy.…”

Section: Discussionmentioning

confidence: 99%

“…However, fluid reflux through unobstructed trocars could have increased vitreous traction on the peripheral retina, leading to retinal breaks. 26 –28…”

Section: Discussionmentioning

confidence: 99%

Small-Gauge Vitrectomy for Macular Surgery Using a Systematic Approach to Wound Closure: 27-Gauge vs 25-Gauge

Christensen,

Thompson,

Nielsen

2023

Journal of VitreoRetinal Diseases

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Purpose: To evaluate the effectiveness of and to compare vitrectomy performed with 25-gauge or 27-gauge instrumentation for macular surgery. The surgical duration, wound closure, and complication rate using a systematic approach to wound closure were assessed. Methods: In this retrospective chart review, 125 25-gauge and 125 27-gauge consecutive small-gauge vitrectomy surgeries for epiretinal membrane, macular hole, vitreomacular adhesion, or a combination were analyzed during and immediately after surgery. Wound closure was performed using a systematic protocol. Results: Baseline characteristics were not statistically different between the 2 groups. The surgical duration was similar with 25-gauge vitrectomy and 27-gauge vitrectomy ( P = .07). Although spontaneous wound closure was common in both groups, it was more common in the 27-gauge group ( P = .22). Intraoperative and postoperative complications were uncommon in both groups. Conclusions: Findings show that 27-gauge vitrectomy is a safe, effective alternative to the more commonly used 25-gauge vitrectomy for macular surgery. Less manipulation was required to achieve wound closure with 27-gauge vitrectomy using a standardized wound-closure protocol. Smaller 27-gauge vitrectomy did not increase surgical time or complications over 25-gauge vitrectomy for macular surgery.

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

Cited by 3 publications

References 11 publications

Valved versus nonvalved cannula small-gauge pars plana vitrectomy for repair of retinal detachments with Grade C proliferative vitreoretinopathy

Valved versus nonvalved cannula small-gauge pars plana vitrectomy for repair of retinal detachments with Grade C proliferative vitreoretinopathy

Ab-interno surgical technique for the implantation of a wireless subretinal prosthesis in mini-pigs

Small-Gauge Vitrectomy for Macular Surgery Using a Systematic Approach to Wound Closure: 27-Gauge vs 25-Gauge

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