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AbstractDO.14.11 Subretinal fluid drainage without intentional retinotomy in vitrectomy using endoscope for retinal detachment Koga T.1, Shimomura Y.1, Ishikawa S.1, Hirata A.1, Okinami S.1, Torii H.2, Fujimoto K.3
1Depertment of Ophthalmology, Saga University, 2Ukinojo Eye Center, 3Fujimoto Eye Clinic, Japan. Objective: To study the usefulness of endoscope-guided subretinal fluid drainage without intentional retinotomy in pars plana vitrectomy (PPV) for rhegmatogenous retinal detachment (RRD).
Methods: A prospective non-comparative study of RRD cases. The study involved twenty two eyes of 22 patients with RRD that received PPV. A 20-guage (0.89mm in diameter) ophthalmic endoscope probe was used for PPV. After vitrectomy, fluid-gas exchange was performed with subretinal fluid drainage through a primary retinal break. During the procedure, the face of the patient was turned in order to make the primary retinal break at the bottom without a surgical microscope or an intentional retinotomy. Each clinical feature was studied and the surgical outcome and complications were evaluated.
Results: All eyes had retinal reattachment by a single operation. After operation patients needed retaining a prone position for few days. (mean±SD: 3.8±2.4 days) No complication related to surgery was observed.
Conclusions: With this new technique using an ophthalmic endoscope, we could perform fluid-gas exchange and subretinal fluid drainage during PPV for RRD in any direction by turning the patients face without limitation by using surgical microscope. Patients did not need retaining a prone position for a long time after operation because of no intentional retinotomy in posterior side of the retina. Endoscope-guided fluid-gas exchange and subretinal fluid drainage through a primary retinal break are minimally invasive, safe and effective procedure in PPV for RRD. Use of the endoscope can expand the strategy of the ophthalmic surgery and provide a beneficial outcome.
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