Two-port pars plana vitreomacular surgery without endoillumination

Abstract

To present a two-port endovitreal surgery technique without endoillumination as a method of choice for sparing surgery of the macular area. Study group included 16 patients (16 eyes) with cataract and macular pathology (8 - with a macular hole (MH) and 8 - with epiretinal fibrosis). Preoperative mean best corrected visual acuity (BCVA) was 0.15±0.10. The maximum follow-up period lasted 6 months. All surgeries were performed by the same specialist using surgical microscope OMS-800™ ('Topcon') fitted with visualization system OFFISS (Optical Fiber-free Intravitreal Surgery System) and 3D visualization system NGENUITY (Alcon). In each case, cataract phacoemulsification with IOL implantation was performed prior to two-port 25-27G pars plana vitrectomy. One port was used for placing the irrigation cannula, the other - for injection of various tools. The light of the microscope tube was used for illumination. Light and color parameters were set up using Alcon NGENUITY 3D visualization system for the microscope light to be used at minimal required intensity that achieved adequate, clear image. The two-port surgery was successfully performed in all 16 patients of the study group. Neither intraoperative nor postoperative complications were observed. There was no rise or decrease in intraocular pressure (IOP) within the specified follow-up period. In the postoperative period, anatomical results were evaluated by optical coherent tomography (OCT). The hole was blocked successfully in all cases, and the epiretinal membrane (ERM) could not be determined. Mean BCVA increased to 0.5±0.3. The technique of two-port surgery without endoillumination allows safe and effective surgical treatment of the macular pathology.