带保护针的外部引流技术在玻璃体视网膜手术中的应用

Applications of the Guarded-Needle External Drainage Technique in Vitreoretinal Surgery.

作者信息

Felfeli Tina, Grewal Parampal S, Mandelcorn Efrem D

机构信息

Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada.

Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.

出版信息

Retina. 2023 Dec 1;43(12):2130-2133. doi: 10.1097/IAE.0000000000003483.

DOI:10.1097/IAE.0000000000003483

PMID:35604721

Abstract

PURPOSE

To describe the surgical technique using the guarded-needle external drainage for a wide variety of applications in vitreoretinal surgery.

METHODS

A step-by-step procedure and a surgical video using the guarded-needle external drainage technique are presented. In addition, a series of representative cases with wide-ranging diagnoses who underwent the technique is reviewed.

DESCRIPTION AND TECHNIQUE

The guarded-needle using a 27-gauge thin-walled TSK needle (TSK Laboratory International) and a trimmed 70 buckle sleeve are connected to the active extrusion tubing of the vitrectomy machine. External drainage is performed by actively aspirating subretinal fluid using low active vacuum. The guarded-needle external drainage technique is used in cases with bullous detachments, and small and anterior breaks, when performing scleral buckle, for prevention of underfill when using oil tamponade in cases with choroidal effusion, addressing subretinal gas/air, lysing a subretinal band, draining a suprachoroidal hemorrhage, for diabetic tractional retinal detachments, detachments with no definitive break, and subretinal biopsy in exudative detachments.

CONCLUSION

The guarded-needle external drainage has a wide range of applications in vitreoretinal surgery.

摘要

目的

描述在玻璃体视网膜手术中使用带保护针的外部引流技术用于多种情况的手术方法。

方法

介绍了使用带保护针的外部引流技术的分步操作步骤及手术视频。此外，回顾了一系列接受该技术治疗、诊断范围广泛的代表性病例。

描述与技术

使用27号薄壁TSK针（TSK国际实验室）和修剪后的70号扣带套管的保护针连接到玻璃体切除机的主动引流管。通过使用低主动真空度主动抽吸视网膜下液来进行外部引流。带保护针的外部引流技术用于治疗大泡性视网膜脱离、小的和前部裂孔的病例，在进行巩膜扣带时，用于预防脉络膜积液病例中使用油填充时的填充不足，处理视网膜下气体/空气，溶解视网膜下条索，引流脉络膜上腔出血，用于糖尿病性牵拉性视网膜脱离、无明确裂孔的视网膜脱离以及渗出性视网膜脱离的视网膜下活检。