Outcomes of transconjuctival sutureless 27-gauge vitrectomy for stage 4 retinopathy of prematurity

Shah, Parag K; Prabhu, Vishma; Narendran, Venkatapathy

doi:10.5409/wjcp.v7.i1.62

Cited by 12 publications

(14 citation statements)

References 27 publications

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“…A 2-port approach using an infusing light pipe or standard 3-port vitrectomy using a separate infusion line are both possible. Small gauge instruments (23 or 25-G usually) are commonly used in modern ROP surgery 1–4. A core vitrectomy is performed and traction is released by segmenting the tractional vitreous vectors: ridge to ridge, ridge to periphery, ridge to lens, and the optic disc to ridge.…”

Section: Ropmentioning

confidence: 99%

“…Vitreoretinal surgery for pediatric vitreoretinal diseases, such as retinopathy of prematurity (ROP), familial exudative vitreoretinopathy, and persistent fetal vasculature have evolved over the past several decades. Advances include a wide variety of small-gauge instruments, [1][2][3][4] evidence-based approaches such as lens-sparing vitrectomy (LSV) for stage 4 ROP, [5][6][7] and anti-vascular endothelial growth factor (VEGF) injections as a surgical adjunct. 8,9 The main goal of pediatric retinal detachment surgery is to relieve tractional forces through scleral buckling (SB) and/or vitrectomy to reattachment the retina.…”

Section: Introductionmentioning

confidence: 99%

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Surgical Complications in Retinopathy of Prematurity: Literature Review and Management Strategies

Wakabayashi

Yonekawa

2022

International Ophthalmology Clinics

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Section: Ropmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Surgical Complications in Retinopathy of Prematurity: Literature Review and Management Strategies

Wakabayashi

Yonekawa

2022

International Ophthalmology Clinics

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“…A two-port vitrectomy was originally described with the irrigating light pipe (20 gauge, Alcon [66]) and we have adapted this to use in combination with a 23 or 25 gauge vitrectomy probe. Surgery is also performed using a three or four port system with 23, 25 or 27 gauge vitrectomy [65,81]. If ports are used, care must be taken not to injure the posterior retina or lens during insertion.…”

Section: Vitrectomymentioning

confidence: 99%

“…The infant eye is smaller than the adult eye (Figure 2). Therefore, to reduce the risk of injury of the posterior retina, a 42 band can be cut into a 2×2×1.25mm piece and the cannula placed through the silicone before entering the eye [81,82]. Alternatively, pediatric ports that are shorter than adult can be used.…”

Section: Vitrectomymentioning

confidence: 99%

A review of treatment for retinopathy of prematurity

Hansen

Hartnett

2019

Expert Review of Ophthalmology

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Introduction: Retinopathy of prematurity (ROP) is a leading cause of childhood blindness worldwide.Areas covered: Recent methods to identify and manage treatment-warranted vascularly active ROP are recognized and being compared to standard care by laser treatment in prospective largescale clinical studies. Pharmacologic anti-angiogenic (anti-VEGF) treatment has changed the natural history of vascularly active ROP by reducing stage 3 intravitreal neovascularization and extending physiologic retinal vascularization in many infants. Tractional retinal detachments in stage 4 ROP after treatment with anti-VEGF agents show additional fibrovascular complexity compared to eyes treated with laser only. We review current management and outcomes for vascularly active and fibrovascular retinal detachment in ROP (stages 3, 4, 5 ROP), highlighting the evidence from recent clinical studies. Included are technical details important in surgery for retinal detachment in ROP. Literature searches were employed through PubMed. Expert opinion:Methods in pediatric imaging, safer pharmacologic treatments, and surgical techniques continue to advance to improve future ROP outcomes.

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“…There are different vitrectomy systems used by different VR surgeons, like 20-gauge, 23-gauge, 25 gauge and 27 gauge, depending upon their skills, training institutes and instrument availability but transconjunctival suture less pars plana vitrectomy (TSV) with 23 G or 25 G has become a preferred choice 2,3 . It has certain advantages like small self-sealing incision, decreased post operative inflammation and pain, early recovery and less astigmatism 4,5 . Our study aims to share surgical experience of 266 patients performed by single VR team over three years from 2017 to 2020.…”

Section: Introductionmentioning

confidence: 99%

The Common Indications of Pars plana vitrectomy (PPV) for posterior Segment Ocular diseases in patients from a Private Retina Clinic

Riaz¹,

Mirza²,

Iqbal³

et al. 2021

PJMHS

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Purpose: To evaluate common indications and anatomical outcomes of PPV for posterior segment ocular diseases in patients presenting at private retina clinic in Lahore Study design: Cross sectional survey Methods and materials: Over the period of three years, from 1st April 2017 to 3oth April 2020, all patients fulfilling inclusion criterion, were included in study after approval from hospital ethical committee. After taking history and detailed ocular examination, diagnosis was confirmed by B scan or OCT, Hepatitis B & C screening done. The patient age, gender, laterality of eye, lens status, macular status, type of retinal pathology, type of anesthesia, procedure done and type of vitreous tamponade if used were noted. All procedures were performed by a single surgical team and patients were followed for six months for anatomical success or any complication. Data was analyzed by SPSS 25. Results: Out of 266 total patients, 168 (63.2%) were males and 98 (36.8%) were females. Right eye was involved in 125 (47%) and left in 141 (53%). Age range was from 2 years to 83years, mean age for males was 47.30, for females 48.07 years, median age was 50 years, mean age for GA was 30.62 years and 51.71 for LA patients. The highest incidences of posterior segment ocular problems were observed in patients with age range 51 to 60 years. The commonest indication for posterior segment surgery were RRD seen in 107 (40.23%), ROSO in 51 (19.17%) and vitreous hemorrhage 33 (12.41%). Endophthalmitis was indication in 20 (7.52%), dropped nucleus in 11 (4.13%), Macular hole in 7 (2.63%) and ERM in 3 (1.13%). Asteroid hyalosis, intraocular IOFB and diagnostic vitrectomy were least common indication, each seen in 1 (0.5%) patient. Silicon oil was most commonly used Endo tamponade used in 138 (51.88%) patients. All patients were followed for 6 months with vision and retinal status. All patients who underwent pars plana vitrectomy surgery were stable with anatomical success rate till 6 months postoperatively except 10 (3.76%) who required re do operation for retinal detachment or some other complications. Conclusion: Current practice in ophthalmology shows increased frequencies of internal approach (PPV) for vitreoretinal diseases rather external approach (SB). Silicon oil was most common internal tamponade used. Diabetic retinopathy was important cause of vitreous hemorrhage and TRD. Patients should be educated regarding regular fundoscopy and good systemic control of diabetes. Higher incidence of retinal detachment among all age groups needs awareness and education about its warning ocular symptoms. Key words: PPV (Pars plana vitrectomy), RRD (Rhegmatogenous retinal detachment), SB (Scleral buckling), TRD (Tractional retinal detachment), ROSO (removal of silicon oil), GA (general anesthesia), LA (local anesthesia)

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Outcomes of transconjuctival sutureless 27-gauge vitrectomy for stage 4 retinopathy of prematurity

Cited by 12 publications

References 27 publications

Surgical Complications in Retinopathy of Prematurity: Literature Review and Management Strategies

Surgical Complications in Retinopathy of Prematurity: Literature Review and Management Strategies

A review of treatment for retinopathy of prematurity

The Common Indications of Pars plana vitrectomy (PPV) for posterior Segment Ocular diseases in patients from a Private Retina Clinic

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