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Microincision vitrectomy surgery: experimental visualization and quantification of vitreous contamination
Yumiko Machida1, Hiroyuki Nakashizuka2, Jun Shoji1
1Division of Ophthalmology, Department of Visual Sciences, Nihon University School of Medicine, Nihon University Hospital, 1-6 Kandasurugadai, Chiyoda-ku, Tokyo, 101-8309, Japan.
BMC Ophthalmology
|November 10, 2020
Summary
Microincision vitrectomy surgery (MIVS) can introduce ocular contamination, even with smaller 27-gauge instruments. Surgeons must remain vigilant about potential contamination from the conjunctiva during MIVS procedures.
Area of Science:
- Ophthalmology
- Surgical Innovation
- Ocular Microbiology
Background:
- Microincision vitrectomy surgery (MIVS) is a minimally invasive technique.
- Potential for ocular contamination during MIVS requires investigation.
- An experimental vitreous contamination model (EVCM) was developed.
Purpose of the Study:
- To visualize and quantify vitreous contamination following MIVS.
- To assess contamination risk associated with different MIVS gauge sizes.
- To evaluate the efficacy of an experimental vitreous contamination model.
Main Methods:
- Developed two types of EVCM using porcine eyes and sclera with microspheres.
- Inserted 25-G and 27-G trocar cannulas into the EVCM.
- Quantified contamination using fluorophotometry after saline injection.
Main Results:
- Fluorescent microspheres were detected in all MIVS eyes (10/10 for 25-G and 27-G).
- MIVS procedures showed significantly higher contamination than controls (P < 0.01).
- No significant difference in contamination was observed between 25-G and 27-G MIVS.
Conclusions:
- MIVS, including 27-G, poses a risk of direct ocular contamination.
- Contamination can occur during trocar and infusion cannula insertion/opening.
- Surgeons must maintain awareness of conjunctival contamination risks during MIVS.
