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E. P. Farris; Disposable Portable Battery Operated 23 Gauge Sutureless Vitrectomy for Anterior Chamber Deepening in Cataract Surgery. Invest. Ophthalmol. Vis. Sci. 2009;50(13):6113.
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© ARVO (1962-2015); The Authors (2016-present)
To describe the use of a commercially available disposable, portable sutureless vitrectomy unit during cataract surgery to deepen the anterior chamber.
Single surgeon case series utilizing a portable sutureless vitrectomy unit (Intrector(R), Insight Instruments, Inc., Stuart, FL) in cataract surgery when the anterior chamber is extremely shallow or there is excessive posterior pressure with anterior displacement of the lens-iris complex making normal intraocular maneuvers difficult. We used the device in both planned and unplanned cases. The setup occurred within 2 minutes. Topical or peribulbar anesthesia was used in all cases. The disposable portion of the unit is sterile and includes aspiration and vitreous cutting which end in a single 23 gauge probing needle. These are attached to a compact battery operated vitrectomy unit which delivers up to 360 cuts per minute. The needle probe was introduced into the eye trans-conjunctival through the sclera at the pars plana and directed into the vitreous cavity. Direct observation through the surgical microscope was utilized to prevent penetration of the posterior capsule. Vitreous was aspirated through tubing connected to a 3cc syringe while the anterior chamber was observed for deepening. There was no irrigation required. The probe was removed without the need for suturing. The cataract procedure then proceeds.
The method was used in 27 eyes of 19 patients. All 27 eyes had successful pars plana vitrectomy using the unit. The vitrectomy was planned prior to cataract surgery in 9 eyes and unplanned in 18 eyes. Less than 0.5cc of vitreous was removed in all cases. No need for sutures was required. The anterior chamber immediately deepened, allowing phacoemulsification to be performed in all cases. There were no intraoperative complications. Posterior chamber intraocular lenses were placed in all cases in the capsular bag.
The Intrector(R) is a safe, efficient, inexpensive device for use in the operating room setting during cataract surgery when the anterior chamber is crowded or excessive positive posterior pressure exists. Setup is quick and simple and the self-sealing wound prevents the need for large conjunctival incisions and sutures affording a less trumatic surgery.
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