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Lamina puncture: pars plana optic disc surgery for central retinal vein occlusion
Eugene S Lit1, Miltiadis Tsilimbaris, Eustratios Gotzaridis
1Massachusetts Eye & Ear Infirmary, 243 Charles St, Boston, MA 02114, USA.
Objective:
To determine the feasibility of creating a perivascular space adjacent to the central retinal vein at the level of the lamina cribrosa as a potential method of reestablishing perfusion in central retinal vein occlusion.
Methods:
Various designs for a puncture instrument, or lamina puncture lancet, were investigated in cadavers, pigs that had undergone enucleation, and in vivo rabbit eyes.
Results:
A lancet with a sharp cutting edge on one side and an opposing blunt edge is repeatedly able to create a perivascular space with limited optic nerve fiber damage.
Conclusions:
Lamina puncture is technically feasible, and evaluation in carefully selected patients appears warranted.