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25-Gauge Vitrectomy for the Treatment of Complicated Diabetic Tractional Retinal Detachment

  Channels: Retina | Posted 12/4/2012

Drs. Schaal and Sigford present in this video the latest advances in minimally invasive vitreo-retinal surgery techniques. The patient is a 30-year-old gentleman with severe vision loss due to a macula off tractional retinal detachment secondary to proliferative diabetic retinopathy. After performing a core vitrectomy, the fibrous membranes are cut using the core duty cycle setting in which the vitrector is preferentially open and the cut rate is 100 cpm. This replaces the conventional intraocular large gauge scissors otherwise needed to cut these membranes. The now-free fibrous stalk is then carefully trimmed and any adherent vitreous is removed. The same process is repeated to relieve traction from the remaining fibro-vascular membranes. The vitreous is cut with a shaving duty cycle in which the vitrector is preferentially closed and the cut rate is 5000 cpm effectively reducing further traction. Endodiathermy is then applied to the remaining fibrovascular stalks. A retinotomy is created and subretinal fluid is drained under air. Finally, supplemental panretinal endophotocoagulation is performed.

Diabetes • Retina • Retinal detachment, RD