27-Gauge Vitrectomy: Minimal Sclerotomies for Maximal by Ulrich Spandau, Mitrofanis Pavlidis

By Ulrich Spandau, Mitrofanis Pavlidis

This booklet offers step by step directions on how one can 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 type, with preliminary insurance of the “ingredients” (devices and tools) after which meticulous description of practise and function with aiding photos, drawings and movies. moreover, the variations and merits compared to 23G and 25G vitrectomy are highlighted.

Small-gauge vitrectomy has significantly replaced the ways that vitrectomy is played. 27G vitrectomy is the latest and most enjoyable improvement in small-gauge vitrectomy. The therapeutic time is quicker however the small diameter prolongs the period of surgical procedure. This main issue has been conquer with strong new vitrectomy machines and progressive vitreous cutters with slicing blades making 27G vitrectomy as quickly as 25G. This new gear has improved the symptoms for 27G surgical procedures immensely from detachment surgical procedure to retinopathy of prematurity and the appearance of latest tools could make 27G the most useful sooner or later. This e-book, written through authors with large adventure in 27G vitrectomy, will allow surgeons to completely take advantage of its advantages.

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Additional resources for 27-Gauge Vitrectomy: Minimal Sclerotomies for Maximal Results

Sample text

We attach it to the scrub table to fixate the plastic tubing and attach two carbobands at 12 o’clock for the light pipe and at 4 o’clock for the chandelier light (Figs. 11). 1 Light Source The light source is either external or is integrated into the vitrectomy machine. The recent generation of vitrectomy machines (Constellation, Stellaris PC, EVA) has a stronger internal light source which suffices for use of a chandelier light (Fig. 1). 20 2 Optimal Visualization, Optimal Instruments and Optimal Technique Fig.

As a retinal scraper, we use a blunt 27G retrobulbar cannula (Atkinson, Beaver-Visitec, USA). The 27G vitreous cutter can be used more extensively than a 23G vitreous cutter. The today equipment is therefore sufficient for approximately 80 % of all cases. 1 Vitrectomy Set Here you will find all the details of our vitrectomy instrument set, which we use at the University Hospital of Uppsala (Fig. 12). The instruments vary, of course, from hospital to hospital. 1. 2. 3. 4. 1× lid speculum Lieberman.

3 Laser Probe (Fig. 37a, b) Curved and straight laser probes are available in 27G (DORC, Synergetics). Extendable/retractable laser probes are not yet available in 27G. 6 Miscellaneous 39 Fig. 47 Polypropylene 10-0 with 1 curved and 1 straight needle: for scleral fixation of IOL (Alcon) is particularly suitable for the peripheral retina. If a peripheral laser treatment is applied (break, peripheral ischemic retina), the use of a scleral depressor is recommended, which makes the break more accessible and avoids touching the lens.

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