gms | German Medical Science

Purpose: The introduction of mini-invasive surgery systems by Fujii e coll. with the 25 gauge TSV in 2002 and by Eckardt with the 23gauge system in 2005, have revolutioned the approach, the modus operandi and the functional results of the vitreoretinal diseases. Aim of this study is to present the results of mini-invasive surgery in some not typical cases.

Methods: Since November 1st 2006 all vitreoretinal surgical interventions have been performed employing both 25G and 23G systems (512 operations). When necessary we combined the two different systems placing the 25G infusion in the anterior chamber and performing the vitrectomy with the 23G system. Heavy tamponades (PFCL, F6H8, silicon oil 1000cs, heavy silicon oil Oxane HD and Densiron 68) are usually introduced by means of mini-invasive sclerotomies. At the end of each surgery we have carried out a tranconjunctival suture.A combined 20-23G approach to achieve the aspiration of the heavy tamponades.

Results: In comparison with the 20G system the delay in the exchange time has been calculated to be about 20% and 40% using the 23G and the 25G systems, respectively. No intraoperative complications due to the small gauge occurred. In general, the aspiration is more difficult with respect to the introduction of heavy liquids. The annual costs have been increased to 22%.

Conclusions: Mini-invasive surgery allows the treatment of complex vitreoretinal cases, reducing iatrogenic traumatism, with good functional recovery and less traumatism for the congiunctiva and the sclera, in particular in cases with multiple surgeries.