27-Gauge Vitrectomy Minimal Sclerotomies for Maximal Results
This book provides step-by-step instructions on how to operate with 27G instrumentation in a wide range of surgical indications, including vitreous floaters, macular holes, dropped nucleus, retinal detachment, diabetic retinopathy, submacular hemorrhage,
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27-Gauge Vitrectomy Minimal Sclerotomies for Maximal Results
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27-Gauge Vitrectomy
Ulrich Spandau • Mitrofanis Pavlidis
27-Gauge Vitrectomy Minimal Sclerotomies for Maximal Results
Ulrich Spandau Department of Ophthalmology Uppsala University Hospital Uppsala Sweden
Mitrofanis Pavlidis Augencentrum Köln Cologne Germany
Additional material to this book can be downloaded from http://extras.springer.com ISBN 978-3-319-20235-8 ISBN 978-3-319-20236-5 DOI 10.1007/978-3-319-20236-5
(eBook)
Library of Congress Control Number: 2015948217 Springer Cham Heidelberg New York Dordrecht London © Springer International Publishing Switzerland 2015 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. The publisher, the authors and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, express or implied, with respect to the material contained herein or for any errors or omissions that may have been made. Printed on acid-free paper Springer International Publishing AG Switzerland is part of Springer Science+Business Media (www.springer.com)
Preface
Vitreoretinal surgery is developing rapidly. 23G technique was until recently the golden standard and now many surgeons are converting to the 25G technique. And why not a take a step further to 27G? But why do we, the authors, operate in 27G? I (US) started with 20G pars plana vitrectomy. In 2008, I converted to 23G. I was especially enthusiastic about the trocars in combination with the valves because the eye was watertight and the ports easier to access. I converted then to 25G because I needed to operate a newborn with retinopathy of prematurity and I wanted to operate sutureless. I continued then with macular peeling and finally with detachment surgery. Macular peeling is more difficult with 25G because the forceps is softer. But detachment surgery with 25G is wonderful. The sclerotomies are tight and a gas tamponade lasts much longer than with 23G. But I still used sutures in highly myopic eyes. I converted therefore to 27G in long eyes (AXL >25 mm); the globe was now watertight and the tamponade lasted even longer than with 25G. I continued with pediatric eyes because these eyes have a soft sclera and therefore weaker sclerotomies. Macu
