Vitreous Wiping, a new technique for removal of vitreous cortex remnants скачать в хорошем качестве

Vitreous Wiping, a new technique for removal of vitreous cortex remnants

Technique Vitreous Wiping developed by Koen van Overdam Surgery Surgery performed by Koen van Overdam Study Koen van Overdam, Peter van Etten, Jan van Meurs, Sonia Manning Purpose 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 vitreoschisis-induced VCR during vitrectomy. Methods 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). VCR on the surface of the retina were visualised 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 six months. All eyes underwent post-operative macular optical coherence tomography. Eyes without preoperative macular pathology, underwent retinal sensitivity testing and eyes without paracentral pathology underwent visual field analysis. Results VCR could be removed completely in all eyes. There were no intra- or post-operative 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. Conclusions Vitreoschisis-induced vitreous cortex remnants 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.