Cover

Front Matter

Contents

List of Contributors

Preface

Acknowledgments

Vitrectomy Machines, Fluidics, and Small-Gauge Systems

Machines and Cutters: Constellation

Abstract

High-Speed Cutting

Small-Gauge Vitrector Probes

Surgeon-Controlled Duty Cycle

Intraocular Pressure Control

Integrated Laser and Gas Mixing Capabilities

Conclusion

Disclosure Statement

References

Machines and Cutters: Stellaris PC

Abstract

Design of the Stellaris PC

Conclusion

Disclosure Statement

References

Machines and Cutters: VersaVIT – Potential and Perspectives of Office-Based Vitrectomy

Abstract

Office-Based Vitrectomy Limitations

Procedure and Machine Pairing

Basic Surgical Aspects

Disadvantages

Conclusions

References

Enhancing Visual Acuity

Abstract

The Enhancing Visual Acuity System

Getting Acquainted with the Enhancing Visual Acuity System

Results Achieved with the Enhancing Visual Acuity System

Service and Support with the Enhancing Visual Acuity System

Comparison with Existing Technologies

Implications for Industry

Reference s

Fluidics and Cutter Dynamics

Abstract

Infusion System

Aspiration Fluidics and Vitreous Cutting

Venturi versus Peristaltic Pumps

Vitrectomy versus the Phaco Technique

Efficiency

Vitrectomy Dynamics

Cutter Technology

Aspiration Systems

Small Incision Techniques and Advantages

References

23-Gauge Vitrectomy

Abstract

Development of 23-Gauge Vitrectomy

Uses of 23-Gauge Vitrectomy

Advantages

Limitations

Techniques

Instrumentation

Developments in the Pipeline

Implications for Industry

References

25-Gauge Vitrectomy

Abstract

Indications

Instrumentation

Wound Construction and Cannula Removal

High-Speed Vitrectomy and Machine Set

Vitrectomy

Macular Surgery

Retinal Detachment

Giant Break

Management of ProliferativeVitreoretinopathy

Proliferative Diabetic Retinopathy

Challenging and Other Cases

Complications

Conclusions

27-Gauge Vitrectomy

Abstract

Criticisms of Microincision Vitrectomy Surgery

Development of the 27-Gauge System

Efficiency of 27-Gauge Ultrahigh-Speed Vitrectomy

Actual Fragility

Techniques, Indications, and Clinical Experiences with 27- and 27+-Gauge Systems

A Promising Outlook

References

Settings, Techniques, and Technologies

Basic Setup and Disinfection

Abstract

Basic Setup

Disinfection

Preoperative Disinfection of Eyelid Skin

Preoperative Disinfection of the Conjunctival Sac

Intraoperative Disinfection of the Surgical Field

Preparation of 0.25% Povidone-Iodine Solution

References

Wound Construction

Abstract

Instrumentation

Globe Fixation and Site Preparation

Different Types of Incisions

Wound Closure

Complications

Conclusions

Disclosure Statement

References

The Evolution of Endoillumination

Abstract

Safety

Brightness

How Much Light Do We Really Need?

Chandeliers

Tissue Visualization

Future Directions

Disclosure Statement

Reference

Wide-Angle Viewing System

Abstract

History of the Wide-Angle Viewing System

Contact Lens-Type Wide-Angle Viewing System

Non-Contact Lens-Type Wide-Angle Viewing System

References

Vitreous Substitute and Tamponade Substances for Microincision Vitreoretinal Surgery

Abstract

Physical Properties of Tamponades and Clinical Consequences

Perfluorocarbon Liquids

Intraocular Gases

Silicone Oils

Conclusions

References

Phacovitrectomy

Abstract

Patient Selection

Surgical Steps and Mechanics of Phacovitrectomy

Complications

Conclusion

References

23-Gauge Endoscopic Vitrectomy

Abstract

Instrument Development

Clinically Relevant Optical Properties

Clinical Application and Outcomes

Surgical Technique and Pearls and Pitfalls

Conclusion

References

Chromovitrectomy and Vital Dyes

Abstract

Visualization of the Vitreous Using Triamcinolone Acetonide

Staining the Internal Limiting Membrane Using Vital Dyes

Advantages of Chromovitrectomy in Microincision Vitrectomy Surgery

Disclosure Statement

References

Pharmacovitrectomy

Abstract

Pharmacologic Vitreolysis

Intravitreal Antiangiogenic Agents as an Adjuvant to Vitrectomy

Intravitreal Triamcinolone Acetonide as aCoadjuvant to Vitrectomy

Conclusion

References

Suprachoroidal Buckling

Abstract

Suprachoroidal Space

Principles of Suprachoroidal Devices and Materials

Suprachoroidal Buckling for Myopic Vitreomacular Interface Disorders

Suprachoroidal Buckling for Peripheral Breaks

Discussion

References

Intraocular Optical CoherenceTomography

Abstract

References

Management of Specific Diseases

Idiopathic Macular Hole

Abstract

Indications and Preoperative Evaluation

Surgical Techniques

Recent Advancements

Surgical Complications

References

Macular Diseases: Epiretinal Membrane

Abstract

Surgical Procedure

Removal of Epiretinal Membrane

Internal Limiting Membrane Peeling

Postoperative Management

Surgical Outcome and Prognostic Factors

When to Perform Microincision Vitrectomy Surgery

References

Diabetic Macular Edema

Abstract

Diabetic Macular Edema Classification

Medical Therapies for Diabetic MacularEdema

The Role of the Vitreous and Vitrectomy inDiabetic Macular Edema

Surgical Procedure

Vitrectomy: When?

Conclusions

References

Vitrectomy Surgery for Primary Retinal Detachment

Abstract

Surgical Techniques

A Few Pearls for the Safe, Efficient, and Successful Repair of Primary Retinal Detachment

References

Management of Giant Retinal Tears Using Microincision Vitrectomy Surgery

Abstract

Surgical Technique

Complications

Conclusions

References

Proliferative Vitreoretinopathy

Abstract

Etiology, Pathophysiology, and Natural History

Risk Factors

Classification

Management

Basic Surgical Techniques (Preventing/Limiting Proliferative Vitreoretinopathy)

Pharmacological Treatment

References

Surgical Management of Retinal Diseases: Proliferative Diabetic Retinopathy and Traction Retinal Detachment

Abstract

Vitreous Hemorrhage

Tractional Retinal Detachment and Traction and Rhegmatogenous Retinal Detachment

Combined Tractional and Rhegmatogenous Retinal Detachment

Complications

Severe Fibrovascular Proliferation

Difficult Diabetic Vitrectomies

Conclusion

References

Myopic Traction Maculopathy

Abstract

Myopic Foveoschisis

Macular Hole Retinal Detachment

References

Subretinal Hemorrhage

Abstract

Natural History of Subretinal Hemorrhage

Use of Tissue Plasminogen Activator

Submacular Surgery

Pneumatic Displacement

Vitrectomy with Gas Tamponade

Subretinal Pneumatic Displacement

Cotreatment with Anti-VEGF Therapy

Conclusion

References

Surgical Management of Retinopathy of Prematurity

Abstract

Pathophysiology

Surgical Outcomes

Surgical Principles

Lens-Sparing Vitrectomy versus Scleral Buckling

Surgical Techniques

Viewing Systems

Sclerotomies

Gauge Selection

Early Surgery for Aggressive Posterior Retinopathy of Prematurity

Surgical Adjuncts

Vitreolysis

Anti-Vascular Endothelial Growth Factor

Steroids

Dyes

Conclusion

References

Dropped Lens Fragment, DislocatedIntraocular Lens

Abstract

Management of /Nucleus Drop/Retained LensMaterial

Anterior Segment Management

Considerations of Intraocular Lens Placement at Primary Surgery and Timing of Vitreoretinal Intervention

Pars Plana Vitrectomy: Intraoperative Tips and Techniques

Intraocular Lens Dislocation

References

Subject Index

Cover