GÖZDAXİLİ YAD CİSİMLƏRİN XARİC EDİLMƏSİNDƏ 23 GAUGE PARS PLANA VİTREKTOMİYANIN TƏTBİQİ

Abstract

SUMMARY

Objective. To review the preliminary results of 23 gauge pars plana vitrectomy for removal of intraocular
foreign bodies.

Materials and methods
A retrospective review was conducted on 9 eyes of 9 patients, who underwent delayed
surgical removal of intraocular foreign bodies by 23 gauge pars plana vitrectomy in 2009-2010. Follow-up period
was 5 to 18 months. Technique of surgery. Cataract phacoemulsification and IOL implantation was performed in all
except 2 eyes, then standard 23 gauge vitrectomy was performed with posterior hyaloid separation facilitated with
triamcinolone. Additional sclerotomy using MVR blade was created for removal of foreign body, then sutured.
Then surgery was completed with standard 23 gauge sclerotomies with silicone oil (4 cases), gas (4 cases), or air
(1 case) tamponade. In 1 case with retinal detachment diagnosed prior to surgery, scleral buckling was done with
2,5 mm silicone band.

Results
The mean age at the time of surgery was 31,1±11,8 years. All patients were male. Most of foreign
bodies (7 out of 9, 77,8%) were ferrous. Concomitant ocular changes were traumatic cataract (7 cases), vitreous
hemorrhage (7 cases), retinal detachment (1 case), siderosis (2 cases), chalcosis (1 case).
Visual acuity improved in 7 of 9 cases (77,8%), in 4 cases (44,4%) being 0,5 to 1,0. In 1 case vision remained
unchanged, in 1 case deteriorated to light perception. Lower visual results were associated with siderosis bulbi (2
cases), chalcosis (1 case), preoperative retinal detachment (1 case), postoperative retinal detachment (3 patients),
and development of epimacular membrane (2 cases). Repeat surgery was performed in 3 cases (2 for retinal
detachment and 1 for epiretinal membrane), but vision did not improve in these cases.

Conclusion
23 gauge vitrectomy for removal of intraocular foregn bodies yields results comparable to
traditional 20 gauge vitrectomy techniques, described in literature. More observations, longer follow-up needed to
define superiority of different gauge techniques regarding anatomical and functional results.