MODIFIED CURVED ASPIRATION CANNULAS AND END-GRIPPING FORCEPS FOR 25-GAUGE VITRECTOMY ON HIGHLY MYOPIC EYES.

Abstract

Pars plana vitrectomy in highly myopic eyes with an axial length (AL) of over 27.00 mm using instruments with the standard length is more challenging than surgery on eyes with an average length of 22.00 mm to 24.00 mm.1 One of the most difficult maneuvers is to reach the posterior pole of the eye, especially in the case of posterior staphyloma. To reach the posterior retina, the long AL of myopic eyes necessitates positioning vitrector or vitreoretinal instruments at a sharper angle to the visual axis of the viewing system than for emmetropic eyes. In addition, because of an insufficient length of the instrumentation, a slight depression may be created on the eye wall in an attempt to reach the posterior pole. An inadequate length can also result in the instruments or the surgeon's fingers coming in contact with the distal lens of the viewing system or contact macular lens, which obscures or displaces the microscopic view making further manipulations more complicated. This can lead to prolonging the time of the surgical procedure or even rendering it insufficient. Previous data have indicated the possibility of using curved instruments in vitreoretinal surgery.2–5 The use of sliding curved laser probes is well known.5 Extra-long straight cannulas and long-shaft forceps for highly myopic eyes to reach the posterior pole are already commercially available.6 The purpose of this work is to report the use of modified aspiration cannulas and end-gripping forceps to improve access to posterior pole during pars plana vitrectomy in eyes with a large AL.