Guided Trocar Insertion in Highly Myopic Eyes

Area of Science:

• Ophthalmology
• Surgical Innovation

Background:

• Highly myopic eyes present unique anatomical challenges for ophthalmic surgery.
• Accurate preoperative assessment is crucial for safe surgical planning in complex cases.

Purpose of the Study:

• To establish a diagnostic method for safe trocar insertion in pars plana vitrectomy for highly myopic eyes.
• To determine a safe distance for trocar placement (>4.0 mm) in the pars plana of highly myopic eyes.

Main Methods:

• Utilized biometry for axial length and ultrasound biomicroscopy for pars plana length measurement in 30 highly myopic eyes.
• Compared pars plana lengths between highly myopic and emmetropic eyes.
• Validated ultrasound biomicroscopy measurements with intraoperative findings.

Main Results:

• Highly myopic eyes showed a significantly greater mean pars plana length (6.65 mm) compared to emmetropic eyes (4.96 mm) (P < 0.001).
• Ultrasound biomicroscopy measurements closely correlated with intraoperative findings (6.65 mm vs. 6.66 mm, P = 0.950).
• Mean axial length in myopic eyes was 31.11 mm.

Conclusions:

• Ultrasound biomicroscopy is a reliable tool for assessing pars plana length in highly myopic eyes.
• Pars plana vitrectomy trocar insertion can be safely performed at >4.0 mm from the limbus in eyes with axial length >30 mm.