Operating microscope use in scleral buckling Correspondence

Abstract

commonly associated with it. Candida has also been found to be a cause of post-surgical ICK.3 This is the first reported case of non-tuberculous mycobacteria without iatrogenic or accidental corneal trauma. Similarly, 4 we found fourth generation fluoroquinolones effective in treatment and recommend first line use for these cases. As M. abscessus can be found in soil and water, patients at risk of infection should be warned of hygiene to prevent the severe consequences of ICK. Time is of the essence when surgery is required to repair a macula-attached retinal detachment, as progression of the detachment to the macula will influence visual outcome significantly. References2 When nonelective scleral buckling surgery is undertaken for these patients, ideal surgical facilities may not be available to the surgeonFfor example, the eye operating room might be unavailable, while the general operating facility is more accessible. In the absence of the operating microscope under such circumstances, the surgeon will have to rely on loupes or the naked eye to pass partial thickness scleral sutures.The authors suggest the use of the non-dominant hand for passing scleral sutures in certain positions to access parts of the scleral quadrants. In our view, the use of the non-dominant hand leads to considerable loss of control and proprioception, increasing the possibility of an iatrogenic perforation. Also, the frequency of scleral buckling surgery has decreased somewhat, following the universal adoption of extracapsular cataract extraction techniques. 3,4 This has diminished the opportunity for trainee surgeons to develop ambidexterity for scleral suturing manoeuvres.The authors assert that using the operating microscope promotes comfort and good posture, since the surgeon remains seated 'all the time' during the operation. We believe that scleral buckling surgery is necessarily a dynamic operation in which the surgeon can remain seated only some of the time, because indirect ophthalmoscopy must still be performed at various points during the surgery when the surgeon will stand and the microscope will be removed from the field. References

Yırtıklı Retina Dekolmanında Ameliyat Mikroskopu Altında Yapılan Skleral Çökertme Cerrahisi ile Ameliyat Mikroskopu Kullanılmadan Yapılan Skleral Çökertme Cerrahisinin Karşılaştırılması

“…Ameliyat mikroskopunun dezavantajları ise sürekli derinlik ayarlaması gerektirmesi, plano düzlemde çalışma zorluğu ve ameliyat süresini uzatabilmesidir. 12,13,[16][17][18] Brown ve Chignell 19 SÇ prosedüründe görülebilen skleral perforasyon oranını yüksek miyoplarda, ince skleralarda, radial çökertmelerde ve başarısız olan SÇ'nin reoperasyonunda %6 olarak bildirmiştir. Raman ve ark.…”