scholarly journals Cannula breakage during 25G+ minimally invasive vitrectomy: a case report

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zhimin Shu ◽  
Siyan Jin ◽  
Chenli Shan ◽  
Linlin Ma ◽  
Jia Liu ◽  
...  

Abstract Background With the continuous improvement of surgical instruments in vitrectomy, the use of a trocar and cannula not only optimizes the incision process but also facilitates insertion and withdrawal of instruments during the procedure. Nevertheless, incision-related complications have also been reported in the literature. However, cannula fractures during 25G+ minimally invasive vitrectomy have rarely been reported. Case presentation A 62-year-old man underwent 25G+ pars plana vitrectomy for proliferative diabetic retinopathy. At the beginning of the operation, we used a trocar with a cannula to perform the sclerotomy. After the trocar was pulled out, the cannula was not seen on the surface of the sclera. Thus the inside and outside of the eye were carefully searched. The broken cannula tip was found in the ciliary body corresponding to the superonasal sclerotomy site and was subsequently removed. Conclusions Awareness regarding the risk of intraoperative fractures of 25G+ minimally invasive ocular surgical instruments is imperative. Whenever a broken or missing cannula is encountered, the residual part should be immediately extracted to avoid revision surgeries and postoperative complications.

2017 ◽  
Vol 8 (1) ◽  
pp. 35-39 ◽  
Author(s):  
Zhong Lin ◽  
Nived Moonasar ◽  
Rong Han Wu ◽  
Robin R. Seemongal-Dass

Purpose: Traditionally acceptable methods of anesthesia for vitrectomy surgery are quite varied. However, each of these methods has its own potential for complications that can range from minor to severe. The surgery procedure of vitrectomy for symptomatic vitreous floaters is much simpler, mainly reflecting in the nonuse of sclera indentation, photocoagulation, and the apparently short surgery duration. The use of 27-gauge cannulae makes the puncture of the sclera minimally invasive. Hence, retrobulbar anesthesia, due to its rare but severe complications, seemed excessive for this kind of surgery. Method: Three cases of 27-gauge, sutureless pars plana vitrectomy for symptomatic vitreous floaters with topical anesthesia are reported. Results: The vitrectomy surgeries were successfully performed with topical anesthesia (proparacaine, 0.5%) without operative or postoperative complications. Furthermore, none of the patients experienced apparent pain during or after the surgery. Conclusion: Topical anesthesia can be considered for 27-guage vitrectomy in patients with symptomatic vitreous floaters.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Enchi Kristina Chang ◽  
Sanchay Gupta ◽  
Marika Chachanidze ◽  
John B. Miller ◽  
Ta Chen Chang ◽  
...  

Abstract Purpose The purpose of this study is to report the safety and efficacy of pars plana glaucoma drainage devices with pars plana vitrectomy using one of the vitrectomy sclerotomy sites for tube placement in patients with refractory glaucoma. Methods Retrospective case series of 28 eyes of 28 patients who underwent combined pars plana glaucoma drainage device and pars plana vitrectomy between November 2016 and September 2019 at Massachusetts Eye and Ear. Main outcome measures were intraocular pressure (IOP), glaucoma medication burden, best corrected visual acuity, and complications. Statistical tests were performed with R and included Kaplan-Meier analyses, Wilcoxon paired signed-rank tests, and Fisher tests. Results Mean IOP decreased from 22.8 mmHg to 11.8 mmHg at 1.5 years (p = 0.002), and mean medication burden decreased from 4.3 to 2.1 at 1.5 years (p = 0.004). Both IOP and medication burden were significantly lower at all follow-up time points. The probability of achieving 5 < IOP ≤ 18 mmHg with at least 20% IOP reduction from preoperative levels was 86.4% at 1 year and 59.8% at 1.5 years. At their last visit, three eyes (10.7%) achieved complete success with IOP reduction as above without medications, and 14 eyes (50.0%) achieved qualified success with medications. Hypotony was observed in 1 eye (3.6%) prior to 3 months postoperatively and 0 eyes after 3 months. Visual acuity was unchanged or improved in 23 eyes (82.1%) at their last follow-up. Two patients had a visual acuity decrease of > 2 lines. Two eyes required subsequent pars plana vitrectomies for tube obstruction, and one eye had transient hypotony. Conclusions The results of pars plana glaucoma drainage device and pars plana vitrectomy using one of the vitrectomy sclerotomy sites for tube placement are promising, resulting in significant IOP and medication-burden reductions through postoperative year 1.5 without additional risk of postoperative complications. Inserting glaucoma drainage devices into an existing vitrectomy sclerotomy site may potentially save surgical time by obviating the need to create another sclerotomy for tube placement and suture one of the vitrectomy ports.


BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e043371
Author(s):  
Wenbin Zheng ◽  
Shida Chen ◽  
Xiaohu Ding ◽  
Kunbei Lai ◽  
Sainan Xiao ◽  
...  

IntroductionDiabetic retinopathy (DR) is the main cause of adult visual impairment worldwide. Severe non-proliferative DR (sNPDR) is an important clinical intervention stage. Currently, panretinal photocoagulation (PRP) is the standard treatment for sNPDR. However, PRP alone cannot completely prevent NPDR progression. One explanation might be that PRP does not remove the detrimental vitreous that plays an important role in DR progression. Microinvasive pars plana vitrectomy (PPV) was shown to be a safe and effective method to treat late-stage proliferative DR (PDR) by completely removing the pathological vitreous. However, whether PPV is effective in controlling sNPDR remains unknown. In this trial, we aim to compare the effectiveness of microinvasive PPV with that of PRP for sNPDR progression control.Methods and analysisThis single centre, parallel group, randomised controlled trial aims to evaluate the clinical efficacy of microinvasive PPV in preventing the progression of sNPDR compared with PRP. A total of 272 adults diagnosed with sNPDR will be randomised 1:1 to the microinvasive PPV and PRP groups. The primary outcome is the disease progression rate, calculated as the rate of sNPDR progressed to PDR from baseline to 12 months after treatment. The secondary outcomes include the change in best-corrected visual acuity, re-treatment rate, diabetic macular oedema occurrence, change in central retinal thickness, change in the visual field, cataract occurrence and change in the quality of life.Ethics and disseminationThe Ethics Committee of Zhongshan Ophthalmic Center approved this study (2019KYPJ108). The results will be presented at scientific meetings and submitted for publication to peer-reviewed journals.Trial registration numberNCT04103671.


2021 ◽  
Vol 1 (4) ◽  
pp. 394-403
Author(s):  
Rahmat Syuhada ◽  
Toni Prasetya ◽  
Ade Utia Detty ◽  
Merryshol Okhi

ABSTRACT: VISUAL RESULTS OF DIABETES RETINOPATHY PATIENTS POST PARS PLANA VITRECTOMY OPERATION AT PERTAMINA BINTANG AMIN HOSPITAL Background: Diabetic retinopathy is a neovascular complication that is very specific for type 1 diabetes and type 2 diabetes. Based on data according to Basic Health Research (RISKESDAS) in 2018, diabetes mellitus in 2013 reached 1.5% of patients with diabetes, and is increasing. to 2.0% in 2018. Treatment of diabetes mellitus patients with complications of diabetic retinopathy by performing pars plana vitrectomy surgery which is anoperative management that can improve eye visual or restore visual fuction. Research Objectives: To determine the visual outcome in diabetic retinopathy patients after pars plana vitrectomy surgery at Pertamina Bintang Amin Hospital, Lampung Province in 2020.Research Methods: This type of research was cross -sectional. Sampling was done by total sampling. Bivariate data analysis using Paired T-Test.Results: Statistical analysis using Paired T-Test showed the p-value for visualoutcome analysis in diabetic retinopathy patients before and after pars plana vitrectomy surgery was 0.000 (p-value <0.05).Conclusions: There are significant changes in diabetic retinopathy patients visualoutcome before pars plana vitrectomy surgery and after pars plana vitrectomy surgery at Pertamina Hospital Amin Star Lampung Province 2020. Keywords: Diabetic retinopathy, pars plana vitrectomy operation, Visualoutcome INTISARI: VISUALOUTCOME PADA PASIEN RETINOPATI DIABETIK PASCA OPERASI PARS PLANA VITRECTOMY DI RUMAH SAKIT PERTAMINA BINTANG AMIN  Latar Belakang: Retinopati diabetik adalah komplikasi neovaskular yang sangat spesifik untuk diabetes tipe 1 dan diabetes tipe 2. Berdasarkan data menurut Riset Kesehatan Dasar (RISKESDAS) pada tahun 2018, penyakit diabetes melitus di tahun 2013 mencapai 1,5% pasien pengidap diabetes, dan meningkat menjadi 2,0% pada tahun 2018. Penanganan pada pasien diabetes melitus dengan komplikasi retinopati diabetik diantaranya adalah dengan dilakukannya operasi pars plana vitrektomi yang merupakan penatalaksanaan operatif yang dapat memperbaiki visus mata atau memulihkan fungsi penglihatan . Tujuan Penelitian: Untuk mengetahui visualoutcome pada pasien retinopati diabetik pasca operasi pars plana vitrektomi di Rumah Sakit Pertamina Bintang Amin Provinsi Lampung Tahun 2020.Metode Penelitian: Jenis penelitian ini adalah potong silang (Cross-sectioal). Pengambilan sampel dilakukan secara total sampling. Analisis data bivariat dengan Paired T-Test.Hasil Penelitian: Analisis statistik menggunakan uji Paired T-Test menunjukkan p-value untuk analisa visualoutcome pada pasien retinopati diabetic sebelum dan sesudah operasi operasi pars plana vitrektomi sebesar 0,000 (p-value < 0,05).Kesimpulan: Terdapat perubahan yang signifikan pada visualoutcome pasien retinopati diabetik sebelum operasi pars plana vitrektomi dan sesudah operasi pars plana vitrektomi di Rumah Sakit Pertamina Bintang Amin Provinsi Lampung Tahun 2020. Kata Kunci: Retinopati Diabetik, Operasi Pars Plana Vitrektomi, Visualoutcome


Retina ◽  
2011 ◽  
Vol 31 (9) ◽  
pp. 1772-1776 ◽  
Author(s):  
Chang-Sik Kim ◽  
Kyoung-Nam Kim ◽  
Woo-Jin Kim ◽  
Jung-Yeul Kim

2020 ◽  
Vol Volume 14 ◽  
pp. 1559-1563
Author(s):  
Hasenin Al-khersan ◽  
Michael J Venincasa ◽  
Amy Kloosterboer ◽  
Jayanth Sridhar ◽  
William E Smiddy ◽  
...  

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