LAS VEGAS — Retinal diseases can be easily visualized and managed through the use of a 23-gauge endoscope, according to a speaker here.
“Endoscopy offers a relatively atraumatic method of visualizing pathology. It allows remarkable visualization in the natural position, and it enables dissection, treatment and management of rarely visualized tissues,” Jeffrey S. Heier, MD, told colleagues at the American Society of Retina Specialists meeting.
The retrospective review analyzed 34 consecutive cases, including retinal detachment, chronic hypotony, non-clearing vitreous hemorrhage, posterior tube placement, endophthalmitis, silicone oil removal and intraocular foreign body, that were repaired entirely with the use of a 23-gauge endoscope.
According to Heier, the 6,000 pixel image that is created by the 23-gauge endoscope allows easy identification of retinal diseases.
“You’re able to go into the far periphery and perform this carefully with good visualization of both the vitreous and its relationship to the retina,” he said.
Postoperatively, 11 of the 15 retinal detachments were reattached with one surgery. Two of six patients with chronic hypotony achieved an IOP of 8 mm Hg or greater, with five patients achieving an increase of 4 mm Hg or greater. All four patients with posterior tube placement achieved an IOP of less than 12 mm Hg with no evidence of occlusion.
“Endoscopy enables visualization, evaluation and management of complicated patients that either would be impossible or would require significant anterior segment manipulation,” Heier said. “This is not something that I use in most cases, or necessarily even in many cases, but when I need it, it can be invaluable.”