Management of Vitreous Loss Management of Vitreous Loss with 700 micron Biaxial with 700 micron Biaxial

TechnologyTechnology

Poster Presentation for ASCRS meeting, Poster Presentation for ASCRS meeting, Chicago 2008.Chicago 2008.

Arturo Pèrez-ArteagaArturo Pèrez-ArteagaMèxicoMèxico

No Finantial Interest.No Finantial Interest.drarturo@prodigy.net.mxdrarturo@prodigy.net.mx

700 micron Cataract Surgery700 micron Cataract Surgery

The smallest incision size for lens surgery until The smallest incision size for lens surgery until present time present time

It gives to the surgeon the ability to It gives to the surgeon the ability to work in a closed enviromentwork in a closed enviroment

This advantage is a true value in cases of This advantage is a true value in cases of posterior capsule rupture. Notice the posterior posterior capsule rupture. Notice the posterior tear in this picture; notice the closed enviroment.tear in this picture; notice the closed enviroment.

Surgical TechniqueSurgical Technique

Do not stop irrigation, just decrease the infusion Do not stop irrigation, just decrease the infusion force.force.

Withdraw from the eye the phaco tip with Withdraw from the eye the phaco tip with positive intraocular pressure.positive intraocular pressure.

Surgical TechniqueSurgical Technique

Insert viscoelastic material with your non-Insert viscoelastic material with your non-dominating hand.dominating hand.

Stop irrigation and retire the infusion until the Stop irrigation and retire the infusion until the anterior chamber is completely distended.anterior chamber is completely distended.

Surgical TechniqueSurgical Technique

Explore the anterior chamber through both Explore the anterior chamber through both incisions..incisions..

Look for vitreous strands and the anterior and Look for vitreous strands and the anterior and posterior capsule remanents.posterior capsule remanents.

Surgical TechniqueSurgical Technique

Perform high speed anterior vitrectomy in a Perform high speed anterior vitrectomy in a biaxial mode.biaxial mode.

Use the same irrigating cannula with a posterior Use the same irrigating cannula with a posterior mode vitrector.mode vitrector.

Surgical TechniqueSurgical Technique

Cut as much vitreous body as you might need.Cut as much vitreous body as you might need. Take care for the anterior capsule remanent.Take care for the anterior capsule remanent. Go behind the iris as you might need; you are Go behind the iris as you might need; you are

working in a complete closed enviroment.working in a complete closed enviroment.

Surgical TechniqueSurgical Technique

Retire the vitrector without stop irrigation.Retire the vitrector without stop irrigation. Switch with your non-dominant hand for visco.Switch with your non-dominant hand for visco. Stop irrigation and retire the irrigating cannula Stop irrigation and retire the irrigating cannula

until the chamber has been formed with visco.until the chamber has been formed with visco.

ResultsResults

In 700 cataract surgeries performed by In 700 cataract surgeries performed by one surgeon with 700 micron tech. 15 one surgeon with 700 micron tech. 15 cases were complicated with posterior cases were complicated with posterior capsule rupture.capsule rupture.

In all cases the management of the In all cases the management of the vitreous was made with the same 700 vitreous was made with the same 700 micron technology in a biaxial approach; micron technology in a biaxial approach; the technique as was described here.the technique as was described here.

ResultsResults

Mean surgical time for anterior vitrectomy Mean surgical time for anterior vitrectomy was 1.12 mins. No surge or collapses was 1.12 mins. No surge or collapses were present. Mean BSS consumption were present. Mean BSS consumption was of 29 cc. Complete visual recovery was of 29 cc. Complete visual recovery was present at 4 weeks. No other was present at 4 weeks. No other complications were noticed in one year complications were noticed in one year follow-up. follow-up.

ConclusionsConclusions

700-micron approach for a biaxial anterior 700-micron approach for a biaxial anterior vitrectomy in cases of vitreous loss during vitrectomy in cases of vitreous loss during cataract surgery is an effective and safe cataract surgery is an effective and safe technique with no short-term technique with no short-term complications.complications.

Thank you very much