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In glaucoma patients, pars plana vitrectomy creates least intraoperative challenges
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CHICAGO — Posterior capsule rupture and a loss of vitreous fluid are the most daunting intraoperative challenges when managing glaucoma patients, according to a speaker here.
“I’m here to share today that I believe in my heart of hearts that if we handle the case properly, if we adhere to the certain principles that our vitreoretinal colleagues do routinely, we can obtain just as good of an anatomic visual outcome as we can with an uncomplicated case, and that involves maintaining a truly closed chamber environment, minimizing turbulence, avoiding unnecessary vitreoretinal traction, and spending the time to completely clean up the anterior segment,” Louis D. “Skip” Nichamin, MD, said at the Glaucoma Subspecialty Day preceding the joint meeting of the American Academy of Ophthalmology and Asia Pacific Academy of Ophthalmology.
Louis D. 'Skip' Nichamin
According to Nichamin, instrumentation should remain inside the eye when vitreous loss becomes obvious, with slow removal of the instrumentation after injection of viscoelastic through the side-port incision in order to maintain chamber space.
Pars plana vitrectomy permits a safer and more thorough vitreous cleanup, is less likely to create vitreous wounds and reduces the amount of vitreoretinal traction, he said.
“I can assure you this may look difficult, but it’s going to increase your efficiency, and I truly believe it’s the safest way to perform an anterior vitrectomy,” Nichamin said.
Disclosure: Nichamin has no relevant financial disclosures.