Lens sparing vitrectomy for rhegmatogenous retinal detachment скачать в хорошем качестве

Lens sparing vitrectomy for rhegmatogenous retinal detachment

This is a video shared by Dr. Aissani Frederic from Bejaia, Algeria. Once manipulations at the vitreous base are significantly harder to perform in phakic patients, we must take some special care to avoid lens touch during lens sparing vitrectomies This is a case of a 59-year-old male patient, with a rhegmatogenous retinal detachment involving macula, in his right eye and a single break inferotemporal. In this case, vitrectomy was performed sparing the crystalline lens. So, at first, you need to place the trocars at 4mm from the limbus in phakic eyes. During all vitrectomy, it is important to keep the instruments away from the lens and avoid as much as possible to cross the vitrector or illumination probe toward the contralateral meridian. In this case, after PVD induction, the surgeon used PFCL to flatten the retina and to condensate the peripheral vitreous. Triamcinolone was used to stain the peripheral vitreous and to facilitate the shaving. Vitreous base excision is made using mild scleral indentation, behind the ora serrata and with low infusion to avoid trauma in the crystalline lens. Movements that make the intorsion, or extortion of the globe, can help to better access the periphery of the retina, without touching the lens The tear is marked with a 25- gauge endodiathermy before the fluid air exchange. This is important especially in cases of small round breaks or in myopic fundus in which it is easier to miss the tear position because of the worse visualization with the gas interface. After completing the FAX, retinopexy was made with the cryo probe, and in the end of the procedure, 20% SF6 gas was chosen as tamponade. This patient had a good outcome with the retina attached after the surgery, and with BCVA of 60/100. Video: Aissani Frederic MD Bejaia 🇩🇿 Edition: Filipe Lucatto MD Juliana Prazeres MD Salvador 🇧🇷