Small-Gauge Vitrectomy for Diabetic Retinopathy by Ulrich Spandau & Zoran Tomic

Author:Ulrich Spandau & Zoran Tomic
Language: eng
Format: epub
ISBN: 9783031262043
Publisher: Springer International Publishing

9.2.3 Posterior Vitreous Separation

It may happen that the posterior hyaloid is completely attached and stretches over the posterior pole. An access from the edge of the posterior hyaloid may not be possible. In this case, the opening of this posterior hyaloid is tricky because neither the vitreous cutter nor a forceps can grasp the attached posterior hyaloid. The trick is to pierce a hole through the posterior hyaloid. We use the retinal scraper Atkinson retrobulbar blunt needle (Fig. 9.15) for this procedure. Try to open the posterior hyaloid with careful scraping (Figs. 9.16 and 9.17). If you do not succeed then use a regular 27G sharp cannula needle, but the handling of this sharp needle requires more caution.

Fig. 9.15A, B: Retinal scraper (25G or 27G retrobulbar cannula Atkinson).This blunt cannula is suitable for opening of the posterior hyaloid or delamination of flat membranes (A, B). The membrane can be lifted up with this blunt cannula and then be removed with the microforceps. Beaver Visitec, 27G retrobulbar cannula Atkinson

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