23-gauge vitrectomy with intraocular foreign body removal via the limbus: An alternative approach for select cases.
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Date
2014-06
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Abstract
Purpose: To study the outcome of removal of retained intraocular foreign bodies (RIOFBs) via limbus
using 23‑gauge transconjunctival sutureless vitrectomy (TSV). Materials and Methods: In this prospective,
non‑comparative interventional case series, fourteen eyes of 14 patients fulfilling the inclusion criteria
were enrolled. They underwent 23‑gauge TSV for management of posterior segment RIOFB and reviewed
at 1 day, 7 days, 6 weeks, 3, 6 and 12 months. Eyes with penetrating eye injury involving cornea or
limbus (corneal injury not so severe to hinder vitrectomy), cataract associated with anterior and/or
posterior capsular tear requiring cataract surgery and posterior segment RIOFB with minimal posterior
segment involvement were included. Main outcome measures include success in removal of RIOFB without
enlarging sclerotomy, ability to preserve capsular support, improvement in visual acuity and complications,
if any. Results: All eyes underwent the successful RIOFB removal through limbal port without enlarging
scleral ports. None of the eyes required suturing of the sclera, cornea or conjunctiva. Anterior capsular rim
could be preserved in all eyes except one. Postoperatively follow up ranged from one year in 8, 6 months
in 4 and 3 months in 2 eyes. The mean logMAR visual acuity at 3, 6, and 12 months showed significant
improvement. There were no intraoperative complications. Postoperative complications include microscopic
hyphema and loose blood in vitreous cavity in one eye. Conclusion: The advantages of 23‑gauge TSV for
removal of RIOFB may be passed on to select cases. RIOFB removal through limbal route obviated the need
for scleral port enlargement and preserved capsular support for early visual rehabilitation.
Description
Keywords
Microincisional vitreous surgery, retained intraocular foreign bodies, transconjunctival sutureless vitrectomy
Citation
Singh Ramandeep, Bhalekar Swapnil, Dogra Mangat R, Gupta Amod. 23-gauge vitrectomy with intraocular foreign body removal via the limbus: An alternative approach for select cases. Indian Journal of Ophthalmology. 2014 June ; 62 (6): 707-710.