ABSTRACT
PURPOSE: To describe a novel technique to use the NGage® Nitinol Stone Extractor for large IOFB extraction. METHODS: We conducted a retrospective case series study by reviewing the data of 4 eyes with retained large IOFB extracted with the use of the NGage® Nitinol Stone Extractor. The study was conducted in a single tertiary referral center on four eyes of four patients with large retained IOFB. Studied eyes were treated by pars plana vitrectomy (PPV) and IOFB extraction by using the NGage® Nitinol Stone Extractor through a limbal incision. RESULTS: Four eyes of four male patients with large Retained IOFB were included in the study. The nature of the IOFB was metallic in 2 eyes, glass in 1 eye or ceramic 1 eye. All the IOFB were removed from a limbal wound. Silicone oil tamponade was required in 3 eyes. Two eyes required reoperation. At 6 months postoperative, the final visual acuity using Snellen chart ranged between PL and 0.1. CONCLUSION: The NGage® Nitinol Stone Extractor can be a useful tool for the extraction of the large retained IOFB.
Subject(s)
Eye Foreign Bodies , Eye Injuries, Penetrating , Alloys , Eye Foreign Bodies/diagnosis , Eye Foreign Bodies/surgery , Eye Injuries, Penetrating/surgery , Humans , Male , Retrospective Studies , VitrectomyABSTRACT
PURPOSE: To describe and evaluate a novel technique of pars plana vitrectomy (PPV) under chandelier illumination which is aided with the vital dyes and perfluorocarbon liquids for the management of the complex diabetic vitrectomy cases. METHODS: We conducted a prospective interventional comparative study on 40 eyes of 36 patients with advanced diabetic eye disease requiring PPV. The study was conducted in a single tertiary referral center. Eyes were divided on 1:1 basis by stratified randomization into two groups. Group 1 had trimanual vitrectomy done assisted with chandelier illumination, perfluorocarbon liquid (PFCL) and vital dyes. Group 2 had the conventional bimanual vitrectomy done assisted with chandelier illumination only. All patients were followed up for a minimum of 6 months after the surgery. RESULTS: Forty eyes of 36 patients with the mean age of 51.42 years (range 28-69) were evaluated. The anatomical success at 6 months could be achieved in all the eyes in both groups. The complete removal of the pre-retinal proliferations could be accomplished in all the eyes in the trimanual PPV group, and only in 85% of the eyes in the bimanual PPV group. Operative time was significantly shorter in the trimanual PPV group (p < 0.001). More eyes in the trimanual PPV group (55.0%) could achieve better vision (> 6/60) 6 months after the operation compared to the bimanual PPV group (50.0%), but this difference was not statistically significant. CONCLUSION: Trimanual PPV is a novel, safe and effective technique that can improve the results of the complex diabetic PPV.
Subject(s)
Diabetes Mellitus , Diabetic Retinopathy , Retinal Detachment , Adult , Aged , Diabetic Retinopathy/diagnosis , Diabetic Retinopathy/surgery , Humans , Middle Aged , Prospective Studies , Retinal Detachment/surgery , Retrospective Studies , Visual Acuity , VitrectomyABSTRACT
PURPOSE: To evaluate the possibility of inducing a posterior vitreous detachment (PVD) by intravitreal injection of streptokinase using electron microscopy and electrophysiological study. METHODS: The current study was performed on 30 eyes of 15 male white rabbits. The rabbits were divided into three equal groups. The right eye of the three groups received an intravitreal injection of streptokinase at three different concentrations (150, 1,500 and 15,000 IU in 0.1 mL balanced salt solution) in the mid vitreous cavity. The left eye in all animals received an intravitreal injection of balanced salt solution and was considered the control group. Electroretinography was performed 1 day and 1 week after injection. The rabbits were killed after 10 days, and the enucleated eyes were processed for transmission and scanning electron microscopic examination. RESULTS: In Group 1, scanning electron microscopy showed the retinal surface covered with thin collagen fibers, whereas in Group 2, a complete PVD with bare retinal surface was seen. Group 3 showed a bare retinal surface with hemorrhagic reaction and toxic effects on the retina by transmission electron microscopy. CONCLUSION: An intravitreal injection of 1,500 IU of streptokinase can lead to a PVD without major toxic effects on the retina.
