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Miyake-Apple view of inner side of sclerotomy during microincision vitrectomy surgery
Makoto Inoue1, Ichiro Ota, Shutaro Taniuchi
1Kyorin Eye Center, Kyorin University School of Medicine, Mitaka, Tokyo, Japan. inoue@eye-center.org
Purpose:
To examine the inner surface of the sclerotomy during microincision vitrectomy surgery by Miyake-Apple view.
Methods:
The anterior half of porcine eyes was attached to a transparent acrylic plate with cyanoacrylate glue. Then, either a 23-gauge or a 25-gauge trocar-cannula was inserted through the sclera obliquely. The inner surface of the entrance site was observed posteriorly by Miyake-Apple view. These images were compared with the endoscopic view of two patients who underwent vitreous surgery for an epiretinal membrane.
Results:
When the trocar-cannula was inserted obliquely, the Miyake-Apple view showed that the ciliary epithelium at the sclerotomy site was stretched. When the trocar-cannula was inserted vertically, the ciliary epithelium was folded, and the folds remained even after the trocar was removed. Vitreous strands were seen incarcerated into the sclerotomy site. In human eyes, a folding of the ciliary epithelium was not clearly seen with the endoscopic view but the incarcerated vitreous was seen.
Conclusion:
The Miyake-Apple view provided a precise, in vivo, observation of the inner surface of the entry site. It disclosed the morphological stress on the ciliary epithelium by the sclerotomy.
