Posters

‘Face down’ anterior vitrectomy

Poster Details

First Author: Z.Ashena UK

Co Author(s): M. Nanavaty                    

Abstract Details

Purpose:

Anterior vitrectomy in unexpected event of posterior capsule rupture and vitreous prolapse is an important skill to master for anterior segment surgeons. To clear the vitreous from anterior chamber various techniques are described with some pros and cons. We describe a simple, safe and effective technique of anterior vitrectomy to reduce the traction on vitreous base.

Setting:

Sussex Eye Hospital, Brighton, UK

Methods:

Comprehensive literature review was performed for papers on anterior vitrectomy techniques. ‘face down’ technique of anterior vitrectomy was described first at and under the plane of posterior capsule. This will effectively remove the prolapsed vitreous around the PCR in the posterior capsular plane and below this plane. Once the vitreous in the pupillary plane and below the posterior capsule is clear using ‘face down’ vitrectomy, the remaining vitreous in the anterior chamber can be removed with a ‘face-up’ anterior vitrectomy above the pupillary plane.

Results:

With ‘face down’ anterior vitrectomy at and below the posterior capsule plane, the traction on the vitreous base can be significantly reduced due to the proximity of the vitrector to the vitreous base. Moreover, the cutting bevel facing posteriorly induces less pull on the vitreous compared to the bevel facing anteriorly. Since the vitrector is held under the iris in single port vitrectomy, it can effectively remove the vitreous, and reduce the risk of vitreous prolapse, cystoid macular oedema and retinal detachment. This technique could be easily employed by junior trainees without the hassle of additional limbal or scleral wound.

Conclusions:

Face-down’ anterior vitrectomy at and below the plane of posterior capsule before removing the vitreous from the anterior part of anterior chamber, provides the ease of limbal anterior vitrectomy with higher efficacy and less risk of traction to the vitreous base even in the hands of inexperienced surgeons.

Financial Disclosure:

None