MICROINSIONAL SURGERY IN OPHTHALMOLOGY
Rasha Elsaid Bedir Ali;
Abstract
The need for small incision has guided technological development in both anterior and posterior segment in ophthalmic surgery. The desire for small incision size is to reduce operating time, surgical trauma and postoperative discomfort.(2)
Microincision cataract surgery (MICS) is an approach to cataract surgery through incision less than 1.8 mm with the purpose of reducing surgical invasiveness, improving at the same time surgical outcomes. The main confirmed advantages of MICS are the control and avoidance of surgically induced corneal astigmatism and the decrease of postoperative corneal aberrations. MICS has been demonstrated to be minimally traumatic surgery, providing better postoperative outcomes than standard small incision phacoemulsification.(10)
Sutureless vitrectomy has rapidly been accepted as an essential part of vitreoretinal surgical setup.The size and structure of the wound along with near intact conjunctival covering makes the incision self-sealing and safe. This allows the vitrectomy instruments to be used without creating an initial limited peritomy to expose sclera, and obviates the need for sutures at the end of the procedure.)99)
The main advantage of MIGS is that they are non-penetrating and/or bleb-independent procedures, thus avoiding the major complications of fistulating surgery related to blebs and hypotony. In addition, most of the MIGS procedures are fast to perform and have a more rapid visual recovery than fistulating surgery. They claim to have a low complication rate, are antimetabolite free, and maintain the conjunctiva integrity in case of ab interno approach. For these reasons, MIGS is suitable for combined cataract surgery. (100)
In strabismus, minimally invasive strabismus surgery (MISS) is done which decrease the chance for limbal ischemia and therefore less postoperative tissue scar.(7)
Dacryocystorhinostomy can be performed both externally and as an endoscopic approach. The endoscopic approach has several advantages, including it provides a better aesthetic result with no external scar, it allows a one-stage procedure to also correct associated nasal pathology that may be causative, it avoids injury to the medial canthus and/or pathologic scar formation, it preserves the pumping mechanism of the orbicularis oculi muscle, active infection of the lacrimal system is not a contraindication to surgery, it is especially superior to the external approach in revision surgery, it is much less bloody than the external approach and because of the facility of the approach, the perioperative time is shorter. The disadvantages of endoscopic surgery include that it requires specialized training in nasal endoscopic surgery and the endoscopic equipment is an expense.(101)
Microincision cataract surgery (MICS) is an approach to cataract surgery through incision less than 1.8 mm with the purpose of reducing surgical invasiveness, improving at the same time surgical outcomes. The main confirmed advantages of MICS are the control and avoidance of surgically induced corneal astigmatism and the decrease of postoperative corneal aberrations. MICS has been demonstrated to be minimally traumatic surgery, providing better postoperative outcomes than standard small incision phacoemulsification.(10)
Sutureless vitrectomy has rapidly been accepted as an essential part of vitreoretinal surgical setup.The size and structure of the wound along with near intact conjunctival covering makes the incision self-sealing and safe. This allows the vitrectomy instruments to be used without creating an initial limited peritomy to expose sclera, and obviates the need for sutures at the end of the procedure.)99)
The main advantage of MIGS is that they are non-penetrating and/or bleb-independent procedures, thus avoiding the major complications of fistulating surgery related to blebs and hypotony. In addition, most of the MIGS procedures are fast to perform and have a more rapid visual recovery than fistulating surgery. They claim to have a low complication rate, are antimetabolite free, and maintain the conjunctiva integrity in case of ab interno approach. For these reasons, MIGS is suitable for combined cataract surgery. (100)
In strabismus, minimally invasive strabismus surgery (MISS) is done which decrease the chance for limbal ischemia and therefore less postoperative tissue scar.(7)
Dacryocystorhinostomy can be performed both externally and as an endoscopic approach. The endoscopic approach has several advantages, including it provides a better aesthetic result with no external scar, it allows a one-stage procedure to also correct associated nasal pathology that may be causative, it avoids injury to the medial canthus and/or pathologic scar formation, it preserves the pumping mechanism of the orbicularis oculi muscle, active infection of the lacrimal system is not a contraindication to surgery, it is especially superior to the external approach in revision surgery, it is much less bloody than the external approach and because of the facility of the approach, the perioperative time is shorter. The disadvantages of endoscopic surgery include that it requires specialized training in nasal endoscopic surgery and the endoscopic equipment is an expense.(101)
Other data
| Title | MICROINSIONAL SURGERY IN OPHTHALMOLOGY | Other Titles | الجراحــــات الميكروسكوبيـــة في طـــب وجراحـــة العيـــون | Authors | Rasha Elsaid Bedir Ali | Issue Date | 2015 |
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