Purpose: To investigate the in vivo sutureless vitrectomy incision architecture using optical coherence tomography (OCT) in the immediate postoperative period.
Design: Prospective, observational case series.
Participants: Thirty-five patients underwent 3-port pars plana vitrectomy using 23-gauge instrumentation combined with 25-gauge infusion at the Wenzhou Eye Hospital.
Methods: All incisions were evaluated using the Carl Zeiss Visante (Dublin, CA) anterior segment OCT imaging system within 5 hours postoperatively.
Main Outcome Measures: Wound architecture (e.g., the length and angle of the incision, presence of gaping), and presence of ciliochoroidal detachment and vitreous incarceration. Seidel test and intraocular pressure (IOP) measurements were performed immediately afterward. Surgical parameters were also recorded.
Results: The mean incision length was 1.15 ± 0.22 mm (range, 0.80-1.55). The mean incision angle was 54.6 ± 13.0 degrees (range, 28.6-80.7). No difference in incision length or angle was found between different quadrants or between 25-gauge and 23-gauge instrumentation. The presence of internal or external gaping and misalignment of the roof and floor of the incisions accounted for 38.1% loss of wound apposition in a bidimensional image. Four eyes (11.4%) had shallow local ciliochoroidal detachments and 2 eyes (5.7%) had minimal vitreous incarceration. The mean postoperative IOP was 12.1 ± 6.2 mmHg (range, 3.5-28.0). The IOP was significantly higher in eyes with good wound apposition as opposed to those with loss of wound apposition (P = 0.011). Of the 4 eyes with hypotony, only 1 presented with leakage, as demonstrated by a positive Seidel test, and incision gaping, as shown by OCT imaging.
Conclusions: The architectural features of gaping, misalignment, and great variation in incision angle on OCT theoretically reduce the security of sutureless sclerotomy in the immediate postoperative period. These features presumably predispose the patient to lower IOP and greater risk of wound leakage.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.ophtha.2010.01.053 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Case report: Surgical closure of a facial defect in an African wild dog () utilizing a transpositional skin flap.
Front Vet Sci
January 2025
College of Veterinary Medicine, Michigan State University, East Lansing, MI, United States.
Veterinary intervention in zoological species can be complicated by species-specific social dynamics. African wild dogs are a pack species and removal or separation of an individual may disrupt established pack hierarchy resulting in conspecific aggression. Therefore, medical interventions that optimize a quick return to health are ideal to minimize the duration of absence from the pack.
View Article and Find Full Text PDFFar Posterior Approach for Rib Fracture Fixation: Surgical Technique and Tips.
JBJS Essent Surg Tech
December 2024
Department of Orthopedics, OhioHealth Health System, Columbus, Ohio.
Article Synopsis
- The video article discusses the far posterior or paraspinal approach for treating posterior rib fractures, which enhances intraoperative visibility and minimizes muscle damage.
- This method helps preserve periscapular strength, achieving up to 95% recovery six months after surgery through muscle-sparing techniques.
- The surgical process involves precise skin incision and careful dissection of muscles like the trapezius, rhomboids, and latissimus dorsi to allow for effective access and treatment of the fractures without significant tissue loss.
Dogs and cats with prepubic hernia often have concurrent injuries and a good short-term outcome.
J Am Vet Med Assoc
November 2024
1Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Texas A&M University, College Station, TX.
Objective: To describe clinical presentation, concurrent injuries, common imaging findings, and short-term outcome of dogs and cats diagnosed with prepubic hernia (PPH).
Animals: 71 dogs and 16 cats.
Clinical Presentation: Medical records were searched at 2 academic referral institutions from August 1, 2008, to August 31, 2023, for dogs and cats diagnosed with PPH.
Flexible Intramedullary Nail Placement in Pediatric Humerus Fractures.
JBJS Essent Surg Tech
November 2024
St. Luke's University Health Network, Bethlehem, Pennsylvania.
Article Synopsis
- Flexible intramedullary nailing is a surgical method used to stabilize humeral shaft fractures in pediatric patients, typically employed when nonoperative treatments are insufficient such as in cases of open fractures or neurovascular compromise.
- The article emphasizes the importance of selecting appropriate entry points for nail insertion, discussing the benefits of anterograde versus retrograde approaches based on individual fracture and patient characteristics, particularly favoring dual distal lateral entry points.
- It highlights the need for careful consideration of pediatric anatomy to avoid nerve damage during the procedure, suggesting detailed preoperative planning for certain entry methods to ensure patient safety and effective treatment.
Compact Arterial Monitoring Device Use in Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA): A Simple Validation Study in Swine.
Cureus
October 2024
Department of Anesthesiology, Uniformed Services University of the Health Sciences, Bethesda, USA.
Article Synopsis
- - Hemorrhage is the main cause of preventable death in trauma situations, leading to military and civilian advancements in medical practices, particularly through the use of tourniquets to manage extremity bleeding and save lives.
- - While tourniquets have significantly decreased deaths from bleeding in military settings, noncompressible hemorrhage still poses a major risk, especially before patients receive definitive medical care.
- - The study explores using a small, disposable pressure monitor during resuscitative endovascular balloon occlusion of the aorta (REBOA) to enhance blood pressure monitoring, facilitate better resuscitation practices, and reduce the need for blood products in extreme environments.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!