Ophthalmic Surg Lasers Imaging Retina. 2022 May;53(5):249-256. doi: 10.3928/23258160-20220408-01. Epub 2022 May 1.
To describe the Port Delivery System with ranibizumab implant insertion procedure.
A surgical procedure based on the clinical trial program in patients with retinal diseases.
An infusion line is placed in the infero-temporal quadrant; a superotemporal quadrant corneal traction suture is recommended. The superotemporal quadrant peritomy of 6 × 6 mm is executed with gentle, purposeful tissue handling. Generous posterior and lateral sub-Tenon's capsule dissection creates laxity for the subsequent closure. Adequate scleral hemostasis is achieved with wet-field cautery to maintain a clean field. The implant is filled under magnification with a customized formulation of ranibizumab. A precise 3.5-mm-long scleral incision (4 mm posterior and parallel to the limbus) is created to ensure proper implant fit. The exposed pars plana undergoes laser ablation to reduce vitreous hemorrhage risk. A pars plana incision is made, and the implant is inserted perpendicular to the globe and seated flush against the sclera. Complete closure of both the conjunctiva and Tenon's capsule with scleral anchoring and mild tissue overhang at the anterior limbus is performed to reduce conjunctival erosion and retraction risks.
The procedure is straightforward yet requires precise preoperative and intraoperative preparation and standardized surgical techniques. [.
描述载 ranibizumab 植入物的输送系统的插入过程。
根据视网膜疾病临床试验方案的一种手术过程。
将输液管放置在下颞象限；建议进行上方颞象限角膜牵引缝线。进行 6×6mm 的上方颞象限的角膜缘切开术，操作要轻柔，有明确的目的。充分向后和外侧行经Tenon 囊下松解术，为后续的闭合创造松弛度。用湿式电凝术充分止血以保持术野清洁。在放大下用定制的 ranibizumab 配方填充植入物。创建一个精确的 3.5mm 长的巩膜切口（4mm 位于后缘并与角膜缘平行），以确保植入物的适当贴合。暴露的睫状体平坦部接受激光消融术，以降低玻璃体积血的风险。进行睫状体平坦部切口，将植入物垂直插入眼球并与巩膜平齐。通过巩膜固定和在前部角膜缘轻度组织悬垂来完成结膜和 Tenon 囊的完全闭合，以降低结膜侵蚀和回缩的风险。
该手术过程简单，但需要精确的术前和术中准备以及标准化的手术技术。
