William Gualtieri1. 1. Surgical Vitreoretinal Service, Asti General Hospital, Asti, Piemonte 14012, Italy. w.gualtieri.retina@eudoramail.com
Abstract
PURPOSE: A pilot study to test a novel, minimal invasive vitrectomy, through one-port pars plana sclerotomy, by 25-G instruments, for selected vitreous, macular and vitreomacular interface disorders. SETTING: institutional. DESIGN: interventional, prospective case series of 14 eyes of 14 patients. The "one-port pars plana vitrectomy" (OPPPV) by 25-G micro-instruments was performed on seven pseudophakic eyes, and the "phacoemulsification OPPPV" (phaco OPPPV) by 25-G on seven presbyopic/cataract phakics. Minimal vitrectomy on eight eyes. Subtotal vitrectomy on six eyes. FOLLOW-UP: 12 months. Main outcome endpoints: surgical feasibility/suitability, patient tolerability, post-operative recovery time. Intra- and post-operative complications were recorded. RESULTS: All OPPPVs by 25 G were completed as planned. Anatomical surgical objectives were fulfilled on all eyes; functional ones on 13 out of 14 eyes. The whole OPPPV group and four of the phaco OPPPV subset of patients tolerated comfortably less than 30' surgical time, and three phaco OPPPV ones less than 45'. Full regimen anti-inflammatory therapy for 2 weeks kept ten eyes out of 14 stable. Post-operatively, two eyes developed a transient alteration of the intraocular pressure. At the end of the follow-up, neither retinal detachment nor endophthalmitis occurred. CONCLUSIONS: OPPPV by 25 G techniques promise to be an effective,comfortable, possible office-based alternative "micro-incisional, minimal invasive vitreous surgery" for selected vitreous, macula and vitreomacular interface disorders. Future research on the safety of the OPPPV by 25 G techniques compared to conventional ones is encouraged.
PURPOSE: A pilot study to test a novel, minimal invasive vitrectomy, through one-port pars plana sclerotomy, by 25-G instruments, for selected vitreous, macular and vitreomacular interface disorders. SETTING: institutional. DESIGN: interventional, prospective case series of 14 eyes of 14 patients. The "one-port pars plana vitrectomy" (OPPPV) by 25-G micro-instruments was performed on seven pseudophakic eyes, and the "phacoemulsification OPPPV" (phaco OPPPV) by 25-G on seven presbyopic/cataract phakics. Minimal vitrectomy on eight eyes. Subtotal vitrectomy on six eyes. FOLLOW-UP: 12 months. Main outcome endpoints: surgical feasibility/suitability, patient tolerability, post-operative recovery time. Intra- and post-operative complications were recorded. RESULTS: All OPPPVs by 25 G were completed as planned. Anatomical surgical objectives were fulfilled on all eyes; functional ones on 13 out of 14 eyes. The whole OPPPV group and four of the phaco OPPPV subset of patients tolerated comfortably less than 30' surgical time, and three phaco OPPPV ones less than 45'. Full regimen anti-inflammatory therapy for 2 weeks kept ten eyes out of 14 stable. Post-operatively, two eyes developed a transient alteration of the intraocular pressure. At the end of the follow-up, neither retinal detachment nor endophthalmitis occurred. CONCLUSIONS: OPPPV by 25 G techniques promise to be an effective,comfortable, possible office-based alternative "micro-incisional, minimal invasive vitreous surgery" for selected vitreous, macula and vitreomacular interface disorders. Future research on the safety of the OPPPV by 25 G techniques compared to conventional ones is encouraged.