1/2. Intraoperative breakage of a 25-gauge vitreous cutter.PURPOSE: To report breakage of a 25-gauge vitreous cutter during vitreous surgery. DESIGN: Interventional case report. methods: A 60-year-old woman was referred for management of an epiretinal membrane at the macula. visual acuity was 20/100 in the affected left eye. Vitreous surgery using a 25-gauge vitrectomy system was carried out with a combination of conventional cataract surgery. RESULTS: The vitreous cutter was lodged within the sclerotomy cannula after peripheral vitrectomy and was pulled together with the cannula. The cannula was reinserted by trocar, but as the floating peeled epiretinal membrane was dissected with the vitreous cutter, the tip of the cutter was broken and was aspirated with the membrane. Stereoscopic microscopy and scanning electron microscopy demonstrated that the edge that had broken at the cutter port was smooth. CONCLUSION: Although 25-gauge instruments remain useful, care should be taken against rare surgical complications related to their fragility.- - - - - - - - - - ranking = 1keywords = breakage (Clic here for more details about this article) |
2/2. Intraoperative breakage of 20-gauge Tano forceps.PURPOSE: To report three cases with breakage of a 20-gauge kryptonite forceps during vitreoretinal surgery. DESIGN: Interventional case report. methods: Pars plana vitrectomy that included a membrane peeling was performed in three patients through standard ports with 20-gauge vitrectomy systems. The peeling procedure was attempted with the end-gripping kryptonite forceps. RESULTS: Intraoperatively, the branch/tip broke and dropped onto the posterior pole. Removal of the broken part was uncomplicated, and the subsequent clinical course was unremarkable. In one case, the handle and branch/tip part were exchanged inadvertently. In the other two cases, neither an exchange nor a maladaptation of the parts was noted. CONCLUSION: An exchange of the hand piece and gripping end may increase the risk of breakage and retinal damage. The delicate gripping tips, however, may break because of inadequate maintenance and/or aging of the material. Intraoperative visual and functional examination is recommended before intraocular use.- - - - - - - - - - ranking = 1.2keywords = breakage (Clic here for more details about this article) |