Small Gauge Vitrectomy: Anesthesia, Incision Technique and Cannula Removal
Sub-tenon anesthesia can be performed in order to perform small-gauge vitrectomy with less invasive modality than peribulbar needle injection, and is more efficient than topical anesthesia as it allows akinesia as well.
Hypotony is a complication related to postoperative wound leakage, so incision construction is critical.
Oblique parallel incisions achieve airtight sclerotomies in 25- and in 23-gauge vitrectomy.
Shaving the cannula from the inside and removing the cannulas with low IOP pressure using a fiberlight are mandatory to avoid vitreous incarcerations.
Endophthalmitis risk is greater in 25-gauge vitrectomy than in 25-gauge, and can be avoided by performing careful patient preparation, by modifying incision construction, and by avoiding vitreous incarceration in the sclerotomies.
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