Channels: Retina | Posted 8/2/2013
I will present my first 27-gauge vitrectomy case using the constellation vision system. This patient had an epiretinal membrane, pseudo exfoliation syndrome and Asteroid Hyalosis
I started surgery with the placement of a 27 g edge plus entry system. My main concern about switching to 27 g was about the cutting efficiency and its ability to provide good illumination. It is clear in this video that cutting efficiency is excellent. I used a cut rate of 75 hundred cuts per minute and proportional vacuum. The Asteroid hyalosis is a good way to demonstrate the good fluidics of this 27gauge vitrectomy. The time to complete the vitrectomy was similar to the time spent using a 25 plus vitreous cutter. The illumination is great also with the standard illumination probe. I now proceed to stain the ILM with brilliant blue g dye. I aspirate the dye and with 27 gauge Grieshaber End grasping forceps attached to the Constellation pneumatic handle I perform the peeling of the ILM in a circular fashion.
Notice the good grip this forcep has, enabling me to peel the ilm in a block avoiding ILM tears
Once the vitrectomy is done I fill the anterior chamber with OVD and I place Grieshaber iris hooks. An anterior circular capsulorhexis is performed. Phacoemulsification is performed with the constellation. Look at the great anterior chamber stability throughout all of the procedure. For phacoemulsification, I use the OZil torsional handpiece technology. I find that torsional phaco enhances my ability to safely and effectively manage cases such as this pseudoexfoliation syndrome. I now aspirate the cortex with the polymer curved tip and an Acrysof IOL is placed in the bag under Provisc. The OVD is aspirated and the cannulas are removed, with all three incisions being self-sealing.
My first impression using this new system was excellent and I encourage doctors to give it a try. This is the 10-day postop slit lamp photograph, fundus photograph and OCT image with an excellent recovery and a 20/30 uncorrected visual acuity.
Cataract Surgery • Combined Surgery Techniques • Retina • Supplements2013 • Vitrectomy