Abstract
BackgroundTo visualize and quantify vitreous contamination following microincision vitrectomy surgery (MIVS) using an experimental vitreous contamination model (EVCM).MethodsEnucleated porcine eyes with fluoresbrite carboxylate microspheres applied to the conjunctival surface were used as a type 1 EVCM. Twenty-five- or 27-gauge (G) trocar cannulas were inserted through the conjunctiva and sclera, followed by the placing and opening of an infusion cannula. These procedures were monitored by an intraocular fiber catheter. Secondly, condensed microspheres were applied to an excised sheet of porcine sclera to serve as type 2 EVCM. Twenty-five- or 27-G trocar cannulas were inserted perpendicularly through the top of the sclera where the condensed microspheres were applied, an infusion cannula was inserted, 0.1 mL of saline solution injected through the infusion cannula, and samples collected. The fluorescence strength of samples was then measured using fluorophotometry.ResultsWe visually detected fluorescent microspheres in 10/10 eyes with 25-G and 10/10 with 27-G MIVS. In the experimental quantification study, each MIVS gauge value was significantly higher than the control (P < 0.01). However, there was no significant difference between 25-G and 27-G MIVS.ConclusionsMIVS carries the risk of introducing contamination directly into the eyes when the trocar cannula is inserted and infusion cannula is opened, even when a 27-G MIVS is used. Our study has shown it is essential that the surgeon be aware of the possibility of introducing contamination from the conjunctiva at all times during MIVS.
Highlights
To visualize and quantify vitreous contamination following microincision vitrectomy surgery (MIVS) using an experimental vitreous contamination model (EVCM)
When 25-G MIVS was first developed and its use broadened, it was reported that endophthalmitis occurred more frequently with MIVS than with conventional 20-G vitrectomy
The incidence of post–MIVS endophthalmitis seems to have reduced due to preventative strategies, even in the latest review of endophthalmitis after 25-G MIVS, Machida et al BMC Ophthalmology (2020) 20:441 the occurrence rate of endophthalmitis has still been higher than that of 20-G vitrectomy
Summary
To visualize and quantify vitreous contamination following microincision vitrectomy surgery (MIVS) using an experimental vitreous contamination model (EVCM). Microincision vitrectomy surgery (MIVS) has become more common, making vitrectomy a safer procedure. Serious complications, such as postoperative retinal detachment and postoperative endophthalmitis, are still sporadically observed. When 25-G MIVS was first developed and its use broadened, it was reported that endophthalmitis occurred more frequently with MIVS than with conventional 20-G vitrectomy. Endophthalmitis was reported to be 12 or 28 times more likely to develop after 25-G MIVS than 20-G MIVS [1, 2]. In 2010, Oshima et al developed 27-G vitrectomy [3], and it has been gaining popularity, the postoperative endophthalmitis rate has not yet been reported
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