By Ulrich Spandau, Mitrofanis Pavlidis
This ebook offers step by step directions on easy methods to function with 27G instrumentation in a variety of surgical symptoms, together with vitreous floaters, macular holes, dropped nucleus, retinal detachment, diabetic retinopathy, submacular hemorrhage, retinopathy of prematurity and lots more and plenty trauma. All surgical procedures are approached in cookbook style, with preliminary insurance of the “ingredients” (devices and tools) after which meticulous description of training and function with helping images, drawings and video clips. moreover, the variations and merits compared to 23G and 25G vitrectomy are highlighted.
Small-gauge vitrectomy has noticeably replaced the ways that vitrectomy is played. 27G vitrectomy is the newest and most fun improvement in small-gauge vitrectomy. The therapeutic time is quicker however the small diameter prolongs the length of surgical procedure. This drawback has been triumph over with strong new vitrectomy machines and progressive vitreous cutters with slicing blades making 27G vitrectomy as quickly as 25G. This new apparatus has accelerated the indicators for 27G surgical procedures immensely from detachment surgical procedure to retinopathy of prematurity and the arrival of recent tools could make 27G the premier sooner or later. This booklet, written via authors with large event in 27G vitrectomy, will allow surgeons to completely take advantage of its advantages.
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Extra resources for 27-Gauge Vitrectomy: Minimal Sclerotomies for Maximal Results
38) The fragmatome can be used to emulsify a dropped nucleus in the vitreous cavity. It is available in 23G but is used without a trocar cannula. A fragmatome is difficult to use. On the one hand, it is less powerful than a normal phaco handpiece. On the other hand, it can exert high levels of suction in the posterior segment. Aspiration of the vitreous or the retina into the handpiece must be avoided. Lens fragments tend to jump away from the needle tip. In such cases, one must aspirate the fragments in the needle tip before emulsification.
If a fluid or gas is injected into the eye, the intraocular pressure increases. This problem can be avoided by the use of a special infusion cannula, which simultaneously injects and removes fluid (double-barrelled cannula). 3 Trocar Forceps (Figs. 15) Indication: For manipulation of trocars. A very useful forceps for any kind of manipulation of trocars. 4 Scleral Marker (Figs. 5 mm for pseudophakic and 4 mm for phakic eyes. Many manufacturers incorporate a marker in the handle of the trocar inserter.
12 After removal of the trocars. The sclerotomies are watertight, require no suture and no hypotony is present the day after. This is an excellent feature for long eyes and pediatric eyes 5. Retinal detachment: Tight globe, less leakage resulting in better tamponade 6. Lens exchange: Less hypotony compared with 23G 27G Is Less Useful for the Following Pathologies These indications have a low risk of postoperative hypotony. There is not really a difference between 23G and 25G regarding this important feature.