Wydanie 3/2013
str. 30

Ocena wejść twardówkowych po witrektomii 25-g i 27-g w obrazie ultrasonografii biomikroskopowej

The Ultrasound Biomicroscopy Evaluation of 25-g and 27-g Vitrectomy Sclerotomies

Maria Kmera-Muszyńska1,2, Magdalena Ulińska1,2, Tomasz Gałecki2

1Katedra i Klinika Okulistyki II Wydziału Lekarskiego Warszawskiego Uniwersytetu Medycznego w Warszawie
Kierownik: prof. dr hab. n. med. Jerzy Szaflik
2Samodzielny Publiczny Kliniczny Szpital Okulistyczny w Warszawie
Kierownik: prof. dr hab. n. med. Jerzy Szaflik


Summary: Sclerotomies performed during pars plana vitrectomy may lead to many serious complications. Delayed healing and leakage of surgical wound may cause incarceration of the vitreous body followed by break appearance at the vitreous base and retinal detachment.
Introduction of microinvasive vitreoretinal surgery systems with very small canulas use to entrance the instruments is dedicated to decreased the number of complications.
The aim of our study was to evaluate the process of sclerotomies healing after 25-gauge and 27-gauge vitrectomies using ultrasound biomicroscopy.
We analysed sclerotomies shape, presence of leakage and possible complications after 30 vitrectomies (90 ports).
On the second day after surgery 3 sclerotomies were opened and 2 of them had to be sutured. 7 days after vitrectomy 41.5% of 27-g sclerotomies were healed and none of 25-g was. 15 days after surgery 100% of 27-g and 90.7% of 25-g ports were healed. We observed incarceration of vitreous body in the internal part of the sclerotomy in 10 cases.
In one patient after uncomplicated surgery we observed vitreous haemorrhage. Ultrasound biomicroscopy on the second post-operative day showed precisely the source of bleeding nearby the sclerotomy and on the seventh day it showed vitreous base detachment, which withdrawn after 40 days.
In conclusion, the process of sclerotomy healing is faster in 27-g than in 25-g vitrectomy. Oblique incision of the sclera makes sclerotomies more tight. Ultrasound biomicroscopy is beneficial in evaluation of eye structures located at the border of anterior and posterior segment, which are usually invisible during ophtalmoscopic examination.

Słowa kluczowe: mikroinwazyjna witrektomia, sklerotomia, ultrasonografia biomikroskopowa.

Keywords: microinvasive vitrectomy, sclerotomy, ultrasound biomicroscopy.


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