Program list

SYMPOSIUM: WEAPONS CHOICES
SECTION: Techniques and devices
Moderators: Jean-Marie Parel, Frank Koch
Sunday, September 14th, 2003 ; 14:00 - 16:00

TECHNIQUES FOR THE MANAGEMENT OF ANTERIOR & SUBRETINAL PVR
Steve Charles, MD
United States

Purpose: To describe the advantages and disadvantages of various methods used to manage anterior PVR based on a single surgeon, in a prospective, consecutive series of 1418 operated cases.
Methods: Detailed description of methods used by the author and comparison to other methods that have been described. Techniques to be described include: 1. Scissors segmentation of narrow antero-posterior component using fine curved scissors, 2. InnoVit cutter with flow limiting via high cutting rates for resection of broad antero-posterior component, 3. Circumferential retinectomy, 4. Scissors segmentation of circumferential component, 5. diamond coated forceps for inside-out peeling of epiretinal membranes, 6. punch-thru retinotomy to remove subretinal dendrites, 7. vitrectomy and retinectomy under air, 8. permanent silicone oil, use of the Chang end-aspirating laser probe for fluid-air exchange and all internal drainage of subretinal fluid, 9. small posterior drainage Retinotomies
Results: The techniques listed under Methods were found to be more effective than pics, relaxing retinotomy, and outside-in peeling. Permanent silicone oil was found to have no cases of corneal damage and the glaucoma incidence was 11% in a series of 450 cases. Pseudophakic eyes were found to be ideal for utilization of permanent silicone oil.
Conclusions: Anterior PVR surgical management requires a combination of specific techniques each directed at the three components of anterior PVR: antero-posterior, circumferential, and confluence of the anterior vitreous cortex and posterior vitreous cortex. It was also concluded that it is not necessary to remove silicone oil in