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Peripheral Vitreous Behavior: Valved Vs Nonvalved Alcon Edge Plus Entry System

Martin Charles MD

In this video, Martin Charles, MD compares the peripheral vitreous behavior between Alcon's valved and non-valved edge plus entry system in a 23 gauge setting. This is a case of severe asteroid hyalosis. The infusion line is set with non-valved edge plus entry system Note that with direct microscope visualization vitreous incarceration is seen through the infusion cannula The infusion line is plugged and turned on. A second valved cannula is placed for the chandelier. Vitreous incarceration is not seen through the valved cannula even though it is not occluded The Alcon Chandelier is plugged to the valved cannula. Note the stained incarcerated vitreous pointing to the infusion line entrance. The super wide peripheral visualization is obtained thanks to the Volk's HRX Vit lens that enables imaging to the ora. Vitreous is not incarcerated as the trocar is removed from the valved cannula. Then, a non-valved entry is introduced to the left side of the eye. An immediate vitreous incarceration is seen as the trocar is removed from the cannula. While performing vitrectomy, vitreous incarceration is not seen as the vit probe is removed from the eye when using a valved cannula. Vitreous incarceration is seen when the probe is removed from the cannula in the non-valved cannula side. Vitreous incarceration acts like a dangerous valve preventing the BSS from leaking through the cannula. Finally, the rest of the vitrectomy is completed with a standard indirect wide-angle contact lens. In conclusion, we noticed an immediate vitreous incarceration as the trocar is removed form the non valved cannula side. Vitreous is incarcerated when the probe is removed from the cannula in the non-valved cannula side. Avoiding vitreous incarceration with valved cannulas helps us to minimize intraoperative complications such as iatrogenical retinal tears and retinal incarceration in retinal detachment patients.

Posted: 3/06/2013