Management of Vitreous Loss with 700 micron Biaxial Technology

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Management of Vitreous Loss with 700 micron
Biaxial Technology

• Poster Presentation for ASCRS meeting, Chicago
  2008.
• Arturo Pèrez-Arteaga
• Mèxico
• No Finantial Interest.
• drarturo_at_prodigy.net.mx

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700 micron Cataract Surgery

• The smallest incision size for lens surgery until
  present time

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It gives to the surgeon the ability to work in a
closed enviroment

• This advantage is a true value in cases of
  posterior capsule rupture. Notice the posterior
  tear in this picture notice the closed
  enviroment.

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Surgical Technique

• Do not stop irrigation, just decrease the
  infusion force.
• Withdraw from the eye the phaco tip with positive
  intraocular pressure.

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Surgical Technique

• Insert viscoelastic material with your
  non-dominating hand.
• Stop irrigation and retire the infusion until the
  anterior chamber is completely distended.

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Surgical Technique

• Explore the anterior chamber through both
  incisions..
• Look for vitreous strands and the anterior and
  posterior capsule remanents.

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Surgical Technique

• Perform high speed anterior vitrectomy in a
  biaxial mode.
• Use the same irrigating cannula with a posterior
  mode vitrector.

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Surgical Technique

• Cut as much vitreous body as you might need.
• Take care for the anterior capsule remanent.
• Go behind the iris as you might need you are
  working in a complete closed enviroment.

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Surgical Technique

• Retire the vitrector without stop irrigation.
• Switch with your non-dominant hand for visco.
• Stop irrigation and retire the irrigating cannula
  until the chamber has been formed with visco.

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Results

• In 700 cataract surgeries performed by one
  surgeon with 700 micron tech. 15 cases were
  complicated with posterior capsule rupture.
• In all cases the management of the vitreous was
  made with the same 700 micron technology in a
  biaxial approach the technique as was described
  here.

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Results

• Mean surgical time for anterior vitrectomy was
  1.12 mins. No surge or collapses were present.
  Mean BSS consumption was of 29 cc. Complete
  visual recovery was present at 4 weeks. No other
  complications were noticed in one year follow-up.

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Conclusions

• 700-micron approach for a biaxial anterior
  vitrectomy in cases of vitreous loss during
  cataract surgery is an effective and safe
  technique with no short-term complications.

Thank you very much