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SURGICAL EMBOLECTOMY FOR FOVEA-THREATENING ACUTE RETINAL ARTERY OCCLUSION
David R P Almeida1, Zaid Mammo, Eric K Chin
1*VitreoRetinal Surgery, PA, Minneapolis, Minnesota; †Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, British Columbia; ‡Retina Consultants of Southern California, Riverside, California; §Vitreoretinal Service, Departments of Ophthalmology and Visual Sciences, University of Iowa, Iowa City, Iowa; and ¶Omics Laboratory, Iowa City, Iowa.
Purpose:
To describe a technique of surgical intraocular embolectomy in patients with acute fovea-threatening branch retinal artery occlusion.
Methods:
Pars plana vitrectomy with embolectomy involving embolus isolation, dissection, and removal in patients with an acute fovea-threatening arterial occlusion without a patent cilioretinal artery.
Results:
The surgical technique involves a core vitrectomy. The blocked artery is incised using a microvitreoretinal blade, and microsurgical forceps are used to retrieve the embolus. No significant complications were noted. The study technique offers an excellent safety profile and minimizes the risk of vitreous hemorrhage by carefully dissecting the vascular adventitial sheath and isolating the embolus.
Conclusion:
Surgical embolectomy is a viable technique for patients with acute fovea-threatening arterial occlusions without patent cilioretinal artery. Careful dissection and retrieval of the embolus minimizes the risk of vitreous hemorrhage, which is an important improvement in previous techniques for management of acute retinal arterial occlusions.
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