Inviato: Gio 16 Ott, 2008 21:41 Oggetto: ancora a proposito di vitreoctomia sutureless
OSN SuperSite Top Story 10/15/2008
Few complications reported with microincision vitrectomy surgery
WAILEA, Hawaii — Microincision vitrectomy surgery can be used to manage a variety of surgical indications with few complications and a shorter operating time, according to a study presented here.
Federica Genovesi-Ebert, MD, presented data at the American Society of Retina Specialists annual meeting on 5,453 eyes that underwent microincision vitrectomy surgery. All surgeries were performed by the same surgeon between 2003 and 2007 and were then retrospectively reviewed. Macular surgery represented 80% of the surgeries.
Minimal core pars plana vitrectomy was performed in the first 876 cases; complete PPV was done in the remainder. Retinal detachment secondary to retinal break occurred in 12 of the initial patients, but not in any subsequent patients.
"Retinal detachment can be avoided by performing complete vitrectomy for all surgical indications," Dr. Genovesi-Ebert said.
Other complications included IOP instability in the first postoperative week in 5.5% of cases, and 5% of cases required suture placement in at least one sclerotomy site. No intraoperative complications were attributable to the 25-gauge or 23-gauge instruments, and operating time was shortened, Dr. Genovesi-Ebert said.
23-gauge vitrectomy system has benefits over 20- and 25-gauge systems
A 23-gauge vitrectomy system used in 100 consecutive eyes of 100 patients has advantages over 20- and 25-gauge systems.
McGregor N. Lott, MD, and colleagues retrospectively examined patients who underwent elective 23-gauge pars plana vitrectomy for a variety of surgical indications. Results demonstrated postoperative visual acuity improvements in 68% of patients.
The mean preop visual acuity was 20/842 (range, 20/25 to light perception), and the mean postop final visual acuity was 20/429 (range, 20/20 to no light perception).
Mean preoperative IOP was 15 mm Hg compared with a mean 14 mm Hg postop.
The study authors reported no intraoperative complications, but one patient required a change to 20-gauge vitrectomy during silicone oil removal.
The study authors said the reusable 23-gauge system (Dutch Ophthalmic Research Company) offers advantages over the current 25-gauge system, including a higher flow rate, a higher tensile strength and fewer sutures.
Advantages over the 20-gauge system include less traumatic wounds, fewer sutures, quicker operating time and faster recovery, according to the study, published in the October issue of Retina.
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