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Published on: May 15, 2010
Simple new technique for macular pucker peel without forceps
Xhevat Lumi1,2, Beáta Eva Petrovski2, Goran Petrovski2,3,4
1Eye Hospital, University Medical Center Ljubljana, Ljubljana, Slovenia.
Purpose:
This study aimed to describe the effectiveness and evaluate the anatomical and functional results of surgery for macular pucker (MP) peel using a 25-gauge pars plana vitrectomy (PPV) cutter without forceps.
Methods:
This study assessed a prospective consecutive case series of 14 eyes of 14 patients who underwent 25-gauge PPV for MP. The surgical procedure was performed using the new peeling technique. The edge of the membrane was engaged at the opening of the cutter by gradually increasing the vacuum. The peeling process was finished by holding a stable vacuum or regrasping the membrane in the same manner.
Results:
The study included six women and eight men patients with a mean age of 72.3 (range 59-84) years. MP peel was achieved in all cases without the need for microforceps. Patients were followed for at least 6 months. Visual acuity and retinal thickness were obtained 6 months after the surgery. Best corrected visual acuity improved from a mean pre-operative 0.6 on a logMAR scale to post-operative 0.23 (P < 0.001). Mean pre-operative Central Retinal Thickness was significantly reduced from 489.7 to 377.6 μm post-operatively (P < 0.001). There were no intra- or post-operative complications.
Conclusion:
MP peel with a 25-gauge vitrectomy probe could be an alternative simple and safe technique. The technique does not require extra instrumentation. It results in anatomic and functional improvement in all cases.
Insights
Macular pucker (MP) surgery using a 25-gauge vitrectomy probe without forceps is effective. This simplified technique improved vision and reduced retinal thickness in all patients, with no complications.
Area of Science:
- Ophthalmology
- Retinal Surgery
- Surgical Techniques
Background:
- Macular pucker (MP) is an epiretinal membrane that can cause visual distortion.
- Traditional surgical peeling of MP often requires specialized microforceps.
- Developing simpler, effective surgical methods is crucial for retinal surgery.
Purpose of the Study:
- To evaluate the effectiveness of a novel macular pucker peel technique.
- To assess anatomical and functional outcomes of using a 25-gauge pars plana vitrectomy (PPV) cutter without forceps for MP surgery.
- To determine the safety and simplicity of this alternative surgical approach.
Main Methods:
- A prospective case series of 14 eyes with MP underwent 25-gauge pars plana vitrectomy (PPV).
- A new peeling technique was employed, engaging the membrane edge with the vitrectomy cutter's vacuum.
- Membrane peeling was completed by maintaining vacuum or regrasping, avoiding microforceps.
Main Results:
- Macular pucker peel was successful in all 14 cases without requiring microforceps.
- Best corrected visual acuity improved significantly from 0.6 to 0.23 logMAR (P < 0.001).
- Mean central retinal thickness decreased significantly from 489.7 to 377.6 μm (P < 0.001).
- No intraoperative or postoperative complications were reported during the follow-up period.
Conclusions:
- Macular pucker peel using a 25-gauge vitrectomy probe without forceps is a viable, safe, and simple surgical alternative.
- This technique eliminates the need for additional instrumentation like microforceps.
- The method consistently yields positive anatomical and functional results in patients with macular pucker.
