gms | German Medical Science

Purpose: To describe the usefulness of the endoscopy in the vitreoretinal surgery.

Methods: We present several cases of secondary IOL implantation, refractory glaucoma treatment, post-traumatic cases assisted by using a via pars plana endoscope.

Results: Through endoscopic view it is possible to directly evaluate the capsular condition and the extent of iris atrophy, a surgical strategy may be planned and the best type of implant may be chosen. If there are enough capsular remains a sulcus posterior chamber IOL will be implanted. The direct vision of iris surface allows also the IOL fixation on the posterior iris surface. In a complex pathology like refractory glaucoma it is very important to have the possibility to evaluate the condition of the eye before the treatment thus defining the strategy and the possibility to verify directly the cyclodestructive effect of the laser beam, sometimes treating also the retinal surface with the photocoagulation. In this way, we avoid either insufficient or excessive treatments in those cases when the ciliary bodies have already been destroyed by the pathology and the high intraocular pressure is due to obstacle to acqueous flow.

Conclusions: Endoscopy represents a significant improvement in eye surgery for several reasons: 1. better pre-surgical evaluation; 2. direct visualization of otherwise not visible endobulbar segments; 3. evaluation of the results at the end of the procedure. Endoscopy in secondary IOL implants remains one of the most successful applications of endoscopic techniques.