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M. Coppola, M. Azzolini, V. de Molfetta; Oblique Insertion of the Microcannulas in 25–Gauge Transconjuctival Sutureless Vitrectomy for the Treatment of Retinal Detachment . Invest. Ophthalmol. Vis. Sci. 2006;47(13):4639.
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to assess the efficacy of oblique insertion of the microcannula in avoiding postoperative hypotony after transconjuctival sutureless vitrectomy for the treatment of retinal detachment.
16 eyes of 16 patients with rhegmatogenous retinal detachment were consecutively operated. Surgical technique included 3 oblique pars plana isertions for the infusion and the instruments (the microcannulas should be introduced while holding the trocar at an approximately 45° angle to the scleral surface, with a movement tangential to the Limbus), minimal vitrectomy, air–fluid exchange, retinopexy, gas tamponade. Postoperative complications, functional and anatomical results were reviewed; median follow–up is 8 months.
retinal reattachment was obtained in 15/16 eyes. The retinal detachment recurrence underwent 20–gauge vitrectomy with PDMS tamponade. Spectacle corrected visual acuity improved in all eyes. No postoperative hypotony (intraocular pressure < 8 mmHg). Cataract formation occurred in 4/16 eyes during the follow–up.UBM images of the incisions site show absence of vitreous incarceration.
Using the 25–gauge oblique insertion technique, "valve–like" incisions are made, which are similar to the corneal incisions made in cataract surgery. These "valve–like" incisions ensure an excellent seal, avoidingfluid or air loss.
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