Vitreous Wiping, a new technique for removal of vitreous cortex remnants during vitrectomy.
Vitreous Wiping
proliferative vitreoretinopahty
redetachment
vitreoschisis
vitreous cortex remnants
vitreous wipe
Journal
Acta ophthalmologica
ISSN: 1755-3768
Titre abrégé: Acta Ophthalmol
Pays: England
ID NLM: 101468102
Informations de publication
Date de publication:
Aug 2019
Aug 2019
Historique:
received:
24
07
2018
accepted:
11
11
2018
pubmed:
12
12
2018
medline:
19
7
2019
entrez:
12
12
2018
Statut:
ppublish
Résumé
Unremoved vitreoschisis-induced vitreous cortex remnants (VCR) are associated with macular pathology. When present on the retinal periphery, they may play a role in proliferative vitreoretinopathy and retinal detachment after vitrectomy. Existing instruments for their removal involve substantial risk of iatrogenic retinal damage. Purpose of this study was to evaluate the use of a new technique, Vitreous Wiping, for removal of VCR during vitrectomy. Proof-of-concept case series of six eyes (six patients) treated with vitrectomy for various pathologies (macula-on and macula-off retinal detachment, macular hole, macular pucker and vitreous floaters). Vitreous cortex remnants on the surface of the retina were visualized with triamcinolone and removed by Vitreous Wiping with a rectangular piece of polyvinyl alcohol (PVA) held with intra-ocular forceps. Visual acuity and clinical course were assessed during a follow-up of 6 months. All eyes underwent postoperative macular optical coherence tomography. Eyes without preoperative macular pathology, underwent retinal sensitivity testing and eyes without paracentral pathology underwent visual field analysis. Vitreous cortex remnants could be removed completely in all eyes. There were no intra- or postoperative complications. We observed that PVA is soft like a sponge and vitreous sticks to it, making Vitreous Wiping easier and safer, compared to alternative instruments. Visual acuity improved in all eyes. Microperimetry and visual field analysis revealed no abnormalities related to Vitreous Wiping. Vitreoschisis-induced VCR can be removed effectively and safely from the retinal surface by Vitreous Wiping. Larger studies are needed to confirm this promising finding and its potential impact.
Identifiants
pubmed: 30536726
doi: 10.1111/aos.13991
pmc: PMC6766987
doi:
Types de publication
Case Reports
Video-Audio Media
Langues
eng
Sous-ensembles de citation
IM
Pagination
e747-e752Informations de copyright
© 2018 The Authors. Acta Ophthalmologica published by John Wiley & Sons Ltd on behalf of Acta Ophthalmologica Scandinavica Foundation.
Références
J Cataract Refract Surg. 2001 Jul;27(7):982-9
pubmed: 11489564
Br J Ophthalmol. 2002 Dec;86(12):1448-9
pubmed: 12446392
Ophthalmologica. 2004 Jul-Aug;218(4):248-56
pubmed: 15258413
Ophthalmology. 2006 Jun;113(6):1020-7
pubmed: 16690128
Graefes Arch Clin Exp Ophthalmol. 2008 Mar;246(3):333-7
pubmed: 18193261
Graefes Arch Clin Exp Ophthalmol. 2008 Mar;246(3):329-32
pubmed: 18228032
Eye (Lond). 2009 Feb;23(2):248-54
pubmed: 18344953
Dev Ophthalmol. 2008;42:35-42
pubmed: 18535379
Arch Ophthalmol. 2008 Sep;126(9):1191-201
pubmed: 18779477
Eye (Lond). 2009 Aug;23(8):1751-2
pubmed: 18949004
Ophthalmology. 2010 Mar;117(3):567-75, 575.e1
pubmed: 20079922
Br J Ophthalmol. 2011 Mar;95(3):376-80
pubmed: 20584710
Chin Med J (Engl). 2011 Aug;124(16):2474-9
pubmed: 21933590
Eur J Ophthalmol. 2013 Jul-Aug;23(4):564-70
pubmed: 23539456
Ophthalmic Res. 2014;51(1):15-31
pubmed: 24158005
Graefes Arch Clin Exp Ophthalmol. 2014 Dec;252(12):1887-94
pubmed: 25377434
J Ophthalmol. 2015;2015:372564
pubmed: 26421183
Invest Ophthalmol Vis Sci. 2015 Nov;56(12):7324-30
pubmed: 26559478
Ophthalmic Surg Lasers Imaging Retina. 2016 Jan;47(1):90-3
pubmed: 26731218
Acta Ophthalmol. 2017 Feb;95(1):97-102
pubmed: 27681600
Dev Ophthalmol. 2017;59:15-35
pubmed: 28442684
Acta Ophthalmol (Copenh). 1981 Aug;59(4):587-94
pubmed: 7315214
Arch Ophthalmol. 1980 Jul;98(7):1245-7
pubmed: 7396777
Acta Ophthalmol Scand. 1998 Dec;76(6):754-5
pubmed: 9881568