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Technological improvements enhance results, safety of traction retinal detachment surgery
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 Athanasios Nikolakopoulos |
LONDON — Technical improvements enabled by recent developments in small-incision 25-gauge vitrectomy have increased the functional outcomes and safety of traction retinal detachment surgery, according to a speaker here.
"The use of wide-angle observation allows us to visualize distance traction forces," Athanasios Nikolakopoulos, MD, said at the Euretina meeting. "The bimanual approach, with the help of the 25- gauge chandelier light, enables us to lift the membranes with one hand and see where they adhere to the thin retina, avoiding the retinal plane."
Cutting and delamination are performed with the 25-gauge, 5,000-cpm vitreous cutter, avoiding vacuum traction and the use of scissors. The other steps of the procedure are also done under constant visual control.
At the end of surgery, Dr. Nikolakopoulos injects silicone through the 25-gauge trocar using a special cannula to reduce postoperative bleeding and allow for faster visual recovery.
"In the past 2 years, thanks to these technological improvements, we have reduced our intraoperative complication rate by 35%. Retrospective evaluation has shown that we have had 50% better visual results. We are not doing anything new, but the new means we have are making our old techniques more effective, safer and more reproducible," he said.
- Disclosures: Dr. Nikolakopoulos has no relevant financial disclosures.
Vitreoretinal surgery has moved forward over the last 2 years with the new machines that are now available. Very high speed cut rate (5,000-cpm) and bright endo-illumination make transconjunctival 23-gauge and 25-gauge the techniques of choice for most of the cases. Using a wide-angle viewing system also helps a lot. All this allows better vitrectomy and less risk of peripheral breaks. It also shortens the duration of the case and diminishes the pain and the burden of surgery.
– Jean-François Korobelnik, MD
Hôpital Pellegrin, Bordeaux, France
Disclosure: Dr. Korobelnik has no
relevant financial disclosures.