Management of Traumatic Retinal Detachment With Pars Plana Vitrectomy, Scleral Buckling, and Gas Injection

Peyman, Gholam A.; Huamonte, Felipe U.; Rose, Marc

doi:10.1111/j.1755-3768.1975.tb01188.x

Cited by 15 publications

(4 citation statements)

References 8 publications

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“…Although the techniques and instruments have been improved dramatically, circular scleral buckle procedure after vitrectomy still plays an important role in preventing retinal tears posterior to the PEVB in eyes undergoing long surgeries or multiple posterior vitreous detachment (PVD) [14,15,16,17]. Variations of the VBI, which may cause complications [3,18], may also be prevented by circular scleral buckle surgery.…”

Section: Discussionmentioning

confidence: 99%

Multimodal imaging of a micro-anatomical structure in the vitreous base

Han

2022

Preprint

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Background To describe an ultrastructure in the vitreous base (VB) and its micro-anatomical characteristics by multimodal imaging. Methods Light and transmission electron microscopy of the VB were performed on specimens from post-trauma eyes and one healthy donor eye. Intra-operative fundus images associated with VB abnormalities were captured from 4 cases, including 2 retinal detachment (RD) with PVR eyes and 2 post-trauma eyes. Images during micro-anatomical observation of the three specimens were analyzed along with the fundus images obtained during vitrectomy. Results Densely packed collagen fibers were observed by light microscopy between the pigment epithelium layer and uveal tissue within the ora serrata region in specimen 1 and the post-mortem healthy eye, respectively. A similar structure was also observed by transmission electron microscopy interior to the pigment epithelium layer and exposed to the vitreous cavity in specimen 2. The collagen fibers, which were termed ciliary body-choroid-retina (CB-C-R) connector, connects to the vitreous fibers interiorly, ciliary epithelium anteriorly, peripheral retina posteriorly, and uveal tissue exteriorly. The three different RD boundaries related to the posterior edge of the VB, ora serrata, and ciliary epithelium are demonstrated with the micro-anatomical characteristics of the CB-C-R connector. Conclusion The CB-C-R connector exists deep in the VB.

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Section: Discussionmentioning

confidence: 99%

Multimodal imaging of a micro-anatomical structure in the vitreous base

Han

2022

Preprint

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“…The closed pars plana vitrectomy, established by Robert Machemer in 1971, has advanced to the most frequently applied therapy of vitreoretinal pathologies over recent decades [1]. These pathologies include vitreous hemorrhage, complicated retinal detachment, macular hole, intraocular foreign body or endophthalmitis [2][3][4][5][6][7]. Starting with 14-and 17-gauge single-port vitrectomy, O'Malley and Heintz then introduced the 20-gauge, three-port vitrectomy in 1975 [8].…”

Section: Introductionmentioning

confidence: 99%

“…Fig 4. The aspiration of Pluronic gel (g) as a function of cut rate and vacuum pressure for 20-and 23-gauge vitrectomes for the Stellaris ® PC, Constellation ® Vision System, vitrectomy systems…”

mentioning

confidence: 99%

Comparison of modern high-speed vitrectomy systems and the advantages of using dual-bladed probes

Oravecz¹,

Uthoff²,

Schrage³

et al. 2021

Int J Retin Vitr

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Purpose This study analyzes the efficiency of different vitrectomy systems and compares single with double-bladed cutters. Methods The systems EVA™ (DORC), Constellation® Vision System (ALCON), megaTRON S4HPS (Geuder) and Stellaris® PC (Bausch and Lomb) were used. We chose 20G and 23G probes, since not all systems had switched to a smaller G at the time the study was conducted in 2016. Cut rates were varied in increments of 1000 cuts/min from 500 cpm to the system’s maximum and vacuum pressures were varied in increments of 100 mmHg, from 100 to 600 mmHg up to the individual system’s maximum. In this study water, egg white, Pluronic®−F127 gel and isolated porcine vitreous were used as models of human vitreous. The vitrectomy efficiency was calculated from the aspirated mass (g) within 30 s. The aperture of the different vitrectomy probes was filmed with a high-speed camera. Results The area under the curve analysis showed differences in efficiency between vitrectomy systems. For water, a reverse relationship between the aspirated mass and cut rate was shown. By contrast, for most systems aspirated egg white and porcine vitreous showed a non-linear increase or decrease for 4000 cpm and above. For all vitreous surrogates, EVA™’s double-bladed probe aspirated significantly (p < 0.001) more vitreous than its mono-bladed probe. Video recordings showed less vitreous traction for double- in contrast to single-bladed probes. Conclusion We can demonstrate differences in the efficiency of vitrectomy depending on the vitrectomy system used. Double-bladed probes were more efficient and probably safer than single-bladed probes.

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“…2,3 Until the introduction of pars plana vitrectomy (PPV) in the early 1970s by Machemer et al, 4 SB was the only significant treatment alternative for RD. Soon after its introduction, PPV enhancedtheabilitytorepairRDs,particularlyinsettingsofcomplexcases, 5,6 trauma, 7,8 and proliferative vitreoretinopathy (PVR). [9][10][11] The use of PPV has expandedintherepairofRDs,particularly in patients with pseudophakic eyes.…”

mentioning

confidence: 99%

Scleral Buckling vs Vitrectomy

Ryan¹

2010

Arch Ophthalmol

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Management of Traumatic Retinal Detachment With Pars Plana Vitrectomy, Scleral Buckling, and Gas Injection

Cited by 15 publications

References 8 publications

Multimodal imaging of a micro-anatomical structure in the vitreous base

Multimodal imaging of a micro-anatomical structure in the vitreous base

Comparison of modern high-speed vitrectomy systems and the advantages of using dual-bladed probes

Scleral Buckling vs Vitrectomy

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