Cutting-edge vitreoretinal surgery / / Astha Jain, S. Natarajan, SAndeep Saxena, editors

• Record Nr.: UNINA9910484385303321
• Pubbl/distr/stampa: Singapore : , : Springer, , [2021]; ©2021
• ISBN: 981-334-168-8
• Descrizione fisica: 1 online resource (xvi, 464 pages) : illustrations
• Disciplina: 617.746059
• Soggetti: Vitreous body - Surgery; Retina - Surgery; Vitrectomia; Llibres electrònics
• Lingua di pubblicazione: Inglese
• Formato: Materiale a stampa
• Livello bibliografico: Monografia
• Nota di bibliografia: Includes bibliographical references.
• Nota di contenuto: Intro -- Foreword -- Preface -- Contents -- About the Editors -- Part I: Introduction to Vitreoretinal Surgery -- 1: History of Vitreoretinal Surgery -- 1.1 Introduction -- 1.1.1 Pre-Gonin Era -- 1.1.2 Post-Gonin Era -- 1.2 Scleral Buckling -- 1.3 Vitreoretinal Surgery -- 1.4 Learnings from the Past -- 1.5 Conclusion -- References -- Part II: Surgical Anatomy, Imaging and Anaesthesia in Vitreoretinal Surgery -- 2: Surgical Anatomy of Vitreous -- 2.1 Introduction -- 2.2 Embryology -- 2.3 Vitreous Anatomy -- 2.3.1 Vitreous Base and Central Anterior Vitreous -- 2.3.2 Posterior Vitreous Cortex -- 2.3.2.1 Hyalocytes -- Macular Pucker -- 2.4 Molecular Structure -- 2.4.1 Collagen -- 2.4.2 Hyaluronan -- 2.4.3 Other Molecular Components -- 2.5 Vitreo-Retinal Interface -- 2.5.1 Inner Limiting Membrane -- 2.5.2 Intervening Extracellular Matrix -- 2.5.3 Retinal Blood Vessels -- 2.5.4 Vitreomacular Interface -- 2.5.5 Vitreopapillary Interface -- 2.6 Age-Related Changes -- 2.7 Vision Degrading Myodesopsia -- References -- 3: Investigations Aiding in Vitreoretinal Surgery -- 3.1 Introduction -- 3.2 Ophthalmic Ultrasound -- 3.3 Optical Coherence Tomography -- 3.4 Intraoperative Optical Coherence Tomography -- 3.5 Conclusion -- References -- 4: ; Anaesthesia for Vitreoretinal Surgery -- 4.1 Introduction -- 4.2 Preoperative Evaluation and Preparation -- 4.3 Preoperative Instructions -- 4.3.1 Instructions Related to Systemic Medications -- 4.3.2 Fasting Regimen -- 4.4 Regional Anaesthesia -- 4.4.1 Intraconal (Retrobulbar) Block -- 4.4.2 Extraconal (Peribulbar) Block -- 4.4.3 Medial Peribulbar Block -- 4.4.4 Sub-Tenon's Block -- 4.5 Choice of Local Anaesthetic Agents -- 4.5.1 Adjuvants -- 4.6 General Anaesthesia -- 4.6.1 Premedication -- 4.6.2 Induction -- 4.6.3 Maintenance of Anaesthesia -- 4.6.4 Extubation.; 4.7 Special Considerations in General Anaesthesia -- 4.7.1 Intravitreal Gases and Nitrous Oxide -- 4.7.2 VR Surgery Combined with Penetrating Keratoplasty or "Open Sky Situations" -- 4.7.3 VR Surgery Combined with Glaucoma Surgery -- 4.7.4 Combined General Anaesthesia and Regional Anaesthesia for VR Surgery -- 4.8 Postoperative Care -- 4.8.1 Pain Relief -- 4.8.2 Postoperative Nausea and Vomiting -- 4.9 Monitored Anaesthesia Care and Conscious Sedation -- References -- Part III: Techniques and Instrumentation in Vitreoretinal Surgery -- 5: Vitreoretinal Surgery Instruments -- 5.1 Introduction -- 5.2 Basic Physics to Understand Vitrectomy Fluidics, Pumps and Vitreous Cutters -- 5.3 Vitrectomy Pumps -- 5.4 Vitrectomy Outflow -- 5.5 Vitreous Cutters -- 5.6 Fluid Dynamics -- 5.7 Most Common Vitrectomy Systems -- 5.7.1 Constellation Vision System (Alcon) -- 5.7.2 EVA Vitrectomy System (DORC) -- 5.7.3 Stellaris Elite Vision Enhancement System (B&amp -- L) -- 5.8 Conclusion -- References -- 6: Wide-Angle Viewing System and Endoillumimnation -- 6.1 Wide-Angle Viewing Systems -- 6.1.1 Contact WAVs -- 6.1.2 Non-Contact WAVs -- 6.2 Endoillumination -- 6.2.1 Phototoxicity -- 6.2.2 Chandelier Endoillumination -- 6.3 Conclusion -- References -- 7: Sutureless Small-Gauge Vitrectomy -- 7.1 Introduction -- 7.2 Advantages of Small-Gauge Sutureless Pars Plana Vitrectomy -- 7.2.1 Less Traumatic Wound Construction and Closure -- 7.2.2 Less Perioperative and Postoperative Patient Discomfort -- 7.2.3 Comparable Risk of Endophthalmitis to Large-Gauge Vitrectomy -- 7.3 Concerns Regarding Small-Gauge Sutureless Vitrectomy -- 7.3.1 Infusion and Aspiration Flow Rate Limitations on Effective Vitreous Removal -- 7.3.1.1 Improved Vitrectome Flow -- 7.3.1.2 Improved Infusion Flow -- 7.3.1.3 Overall Effect on Operating Time.; 7.3.2 Flexible Instruments Limiting Small-Gauge PPV in Complex Cases -- 7.4 Intraoperative Challenges with Small-Gauge Sutureless Vitrectomy and Suggested Technique Modifications -- 7.4.1 Preventing Hypotony -- 7.4.2 Inefficient Vitreous Removal -- 7.4.3 Inability to Induce Posterior Vitreous Detachment -- 7.4.4 Inability for Transconjunctival Wound to Close -- 7.4.5 Difficulty with Instrument Manipulation -- 7.4.6 Silicone Oil Insertion or Removal -- 7.5 Conclusions -- References -- 8: Endoscopic Vitrectomy -- 8.1 Introduction -- 8.2 History -- 8.3 Advantages -- 8.4 Instrumentation -- 8.5 Indications -- 8.6 Clinical Applications -- 8.6.1 Diagnostic Endoscopy and Prognostication Before Anterior Segment Interventions -- 8.6.2 Retinal Reattachment in Hazy Media -- 8.6.3 Ocular Trauma -- 8.6.4 Retained Intraocular Foreign Bodies -- 8.6.5 Endophthalmitis -- 8.7 Surgical Nuances -- 8.8 Conclusion -- References -- 9: 3D Viewing System in Vitreoretinal Surgery -- 9.1 Introduction -- 9.2 Heads-Up Surgery with the TrueVision® 3D Viewing System -- 9.3 Heads-Up Vitreoretinal Surgery -- 9.4 3D Visualization System Settings in Our Department -- 9.5 Difference of 3D Viewing with Conventional Analog Microscope Viewing -- 9.5.1 Surgical Field -- 9.5.2 Colors -- 9.5.3 Resolution -- 9.5.4 Magnification -- 9.5.5 ; Depth of Field -- 9.5.6 Illumination -- 9.6 Learning Curve -- 9.7 Ergonomics -- 9.8 Additional Intraoperative Information -- 9.9 Problems with 3D Displays -- 9.10 Head-Mounted Displays -- 9.11 Technical Problems -- 9.12 Teaching -- 9.13 The Future of 3D Viewing Systems -- References -- 10: Robotics in Vitreoretinal Surgeries -- 10.1 Introduction -- 10.2 Intraocular Surgical Robotics -- 10.2.1 Early Intraocular Surgical Robotics -- 10.2.2 Recent Intraocular Surgical Robotics.; 10.2.2.1 Johns Hopkins University Steady-Hand Manipulator -- 10.2.2.2 University of Utah -- 10.2.2.3 The MICRON -- 10.2.2.4 Vanderbilt University Intraocular Probe -- 10.2.2.5 University of Leuven, Belgium -- 10.2.2.6 Munich -- 10.2.2.7 Preceyes Surgical System -- 10.2.2.8 Intraocular Robotic Interventional and Surgical System -- 10.3 Future of Vitreoretinal Surgical Robotics -- 10.4 Conclusion -- References -- 11: Tamponading Agents in Vitreoretinal Surgery -- 11.1 Introduction -- 11.2 Physical Properties of Tamponading Agents -- 11.3 Types of Tamponading Agents -- 11.4 Gaseous Tamponading Agents -- 11.4.1 Kinetics of Intraocular Gases -- 11.4.2 Preparation of Gas for Injection -- 11.4.3 Contraindication -- 11.4.4 Complications -- 11.5 Silicone Oil -- 11.5.1 Chemical Property -- 11.5.2 Physical Property -- 11.5.3 Indications for Using Silicone Oil -- 11.5.4 Complications with Silicone Oil -- 11.5.5 Silicone Oil Removal -- 11.6 Heavy Silicone Oil -- 11.6.1 Complications and Adverse Reactions -- 11.7 Perfluorocarbon Liquids -- 11.7.1 Chemical and Physical Properties -- 11.7.2 Indications for Use of PFCL -- 11.7.3 Complications -- 11.8 Conclusion -- References -- Part IV: Retinal Detachment: Surgical Techniques -- 12: Scleral Buckling and Management of Retinal Dialysis -- 12.1 Introduction -- 12.2 History -- 12.3 Preoperative Localization of Break -- 12.4 Relevant Surgical Anatomy -- 12.5 Instrumentation -- 12.5.1 Cryotherapy -- 12.5.2 Silicon Buckles -- 12.5.3 Sutures -- 12.6 Principle of Buckling -- 12.7 Indications -- 12.8 Surgical Steps Along with Intraoperative Complication -- 12.8.1 Anesthesia -- 12.8.2 Conjunctival Peritomy -- 12.8.3 Muscle Bridling -- 12.8.4 Inspection -- 12.8.5 Localizing the Breaks -- 12.8.6 Treating the Retinal Breaks -- 12.8.7 Placing the Exoplants -- 12.8.8 Suture Placement.; 12.8.9 SRF Drainage -- 12.8.10 Adjusting the Height of Scleral Buckle -- 12.8.11 Final Examination -- 12.8.12 Tenon and Conjunctiva Closure -- 12.8.13 Documentation -- 12.8.14 Overview of Surgical Steps -- 12.9 Important Postoperative Complications -- 12.10 Newer Development: Chandelier-Assisted Scleral Buckling -- 12.11 Conclusion -- References -- 13: Pneumatic Retinopexy -- 13.1 Introduction -- 13.2 Patient Selection -- 13.3 Technique -- 13.3.1 Anaesthesia -- 13.3.2 Retinopexy -- 13.3.3 Paracentesis -- 13.3.4 Injection of Gas -- 13.3.5 Indirect Ophthalmoscopy -- 13.3.6 Postop Positioning -- 13.3.7 Choice of Intraocular Gas -- 13.4 Complications -- 13.5 Outcome -- 13.6 Conclusion -- References -- 14: Primary Vitrectomy in Rhegmatogenous Retinal Detachment -- 14.1 Introduction -- 14.2 Indications of Primary Vitrectomy in RRD -- 14.3 Steps of Surgery -- 14.3.1 Conjunctival Peritomy -- 14.3.2 Encerclage -- 14.3.3 Sclerotomy -- 14.3.4 Core Vitrectomy -- 14.3.5 Induction of Posterior Vitreous Detachment -- 14.3.5.1 Other Techniques of PVD Induction -- 14.3.6 Peripheral Vitrectomy -- 14.3.7 Internal Limiting Membrane Removal -- 14.3.8 Identification of Breaks -- 14.3.9 Fluid Air Exchange -- 14.3.9.1 Difficulties during FAE -- 14.3.10 Retinopexy -- 14.3.11 Tamponade -- 14.3.12 Closure of Sclerotomy -- 14.4 Results of Primary Vitrectomy for RRD -- References -- 15: ; Principles in the Management of Proliferative Vitreoretinopathy -- 15.1 Introduction -- 15.2 Risk Factors and Pathogenesis -- 15.3 Pathogenesis of PVR -- 15.4 Surgery in PVR -- 15.4.1 Scleral Buckling in PVR -- 15.4.2 Combined SB+ PPV Versus PPV Alone for PVR -- 15.4.3 Vitrectomy in PVR -- 15.5 Surgical Sequence and Techniques for Established PVR -- 15.5.1 Anesthesia -- 15.5.2 Placement of Transconjunctival Cannulas -- 15.5.3 Management of Lens in PVR.; 15.5.4 Core Vitrectomy and Removal of Vitreous Base.