Management of vitreous loss during cataract surgery under topical anesthesia with transconjunctival vitrectomy system. 2003

V A Shah, and S K Gupta, and K V Chalam
Department of Ophthalmology, University of Florida College of Medicine, Jacksonville, USA.

OBJECTIVE A new technique to manage posterior capsular rupture with vitreous prolapse into the anterior chamber during phacoemulsification under topical anesthesia using the sutureless self-sealing 25-gauge transconjuctival vitrectomy system. METHODS In the event of vitreous prolapse into the anterior chamber, the corneal wound is sutured and cleared of vitreous. A trans conjunctival 25-gauge sclerotomy through the pars plana is made. The high speed 25-guage trans-conjunctival vitrectomy system (TVS-25) under topical anesthesia is introduced and vitrectomy is performed to clear the anterior chamber of vitreous. An anterior vitrectomy is also done. A foldable intraocular lens is subsequently inserted. RESULTS The vitrectomy is performed in a closed chamber maintaining normal intraocular pressure. The high-speed cutter exerts minimal traction on the vitreous. The accessibility to vitreous improves through the pars plana route ensuring more complete removal of the vitreous and restoration of normal anatomy. Topical anesthesia avoids the risks of globe perforation, retrobulbar hemorrhage, and prolonged postoperative akinesia of the eye. CONCLUSIONS The 25-gauge pars plana incision is small and self-sealing. This makes the procedure fast, effective, painless and safe.

UI MeSH Term Description Entries
D007431 Intraoperative Complications Complications that affect patients during surgery. They may or may not be associated with the disease for which the surgery is done, or within the same surgical procedure. Peroperative Complications,Surgical Injuries,Complication, Intraoperative,Complication, Peroperative,Injuries, Surgical,Complications, Intraoperative,Complications, Peroperative,Injury, Surgical,Intraoperative Complication,Peroperative Complication,Surgical Injury
D007903 Lens Capsule, Crystalline The thin noncellular outer covering of the CRYSTALLINE LENS composed mainly of COLLAGEN TYPE IV and GLYCOSAMINOGLYCANS. It is secreted by the embryonic anterior and posterior epithelium. The embryonic posterior epithelium later disappears. Capsule, Crystalline Lens,Capsules, Crystalline Lens,Crystalline Lens Capsule,Crystalline Lens Capsules,Lens Capsules, Crystalline
D007910 Lenses, Intraocular Artificial implanted lenses. Implantable Contact Lens,Lens, Intraocular,Contact Lens, Implantable,Intraocular Lens,Intraocular Lenses,Lens, Implantable Contact
D002387 Cataract Extraction The removal of a cataractous CRYSTALLINE LENS from the eye. Enzymatic Zonulolysis,Phakectomy,Cataract Extractions,Enzymatic Zonulolyses,Extraction, Cataract,Extractions, Cataract,Phakectomies,Zonulolyses, Enzymatic,Zonulolysis, Enzymatic
D003228 Conjunctiva The mucous membrane that covers the posterior surface of the eyelids and the anterior pericorneal surface of the eyeball. Bulbar Conjunctiva,Palpebral Conjunctiva,Plica Semilunaris of Conjunctiva,Plicae Semilunares of Conjunctiva,Tunica Conjunctiva,Conjunctiva, Bulbar,Conjunctiva, Palpebral,Conjunctivas
D004867 Equipment Design Methods and patterns of fabricating machines and related hardware. Design, Equipment,Device Design,Medical Device Design,Design, Medical Device,Designs, Medical Device,Device Design, Medical,Device Designs, Medical,Medical Device Designs,Design, Device,Designs, Device,Designs, Equipment,Device Designs,Equipment Designs
D005128 Eye Diseases Diseases affecting the eye. Eye Disorders,Eye Disease,Eye Disorder
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000772 Anesthesia, Local A blocking of nerve conduction to a specific area by an injection of an anesthetic agent. Anesthesia, Infiltration,Local Anesthesia,Neural Therapy of Huneke,Huneke Neural Therapy,Infiltration Anesthesia
D012421 Rupture Forcible or traumatic tear or break of an organ or other soft part of the body. Ruptures

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