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Intraoperative staining of vitreous body and internal limiting membrane with optimized corticosteroid suspension

Session Details

Session Title: FP-16 Vitreoretinal Surgery IV

Session Date/Time: Sunday 14/09/2014 | 11:00-13:00

Paper Time: 12:52

Venue: Boulevard D

First Author: : P.Lyskin RUSSIA

Co Author(s): :                  

Abstract Details

Purpose:

The aim of the study was to develop the technology of staining by creating and optimizing the corticosteroid suspension, which would be able to stain vitreous body in the vitreous cavity, as well as epiretinal vitreous body, epiretinal membranes and ILM.

Setting:

Triamcinolon acetonide suspension is commonly used during vitreoretinal surgery. It stains epiretinal vitreous but leaves internal limiting membrane (ILM) and the thinnest epiretinal structures unstained. Therefore it is important to create corticosteroid suspension which is able to stain vitreous body, epiretinal membranes and ILM.

Methods:

Scanning electron microscopy with the microscope COM SCAN S2 SEM was used. Particles dimensions of the different corticosteroid suspensions (different brands) were measured. The dimensions of the holes between vitreous fibers were measured both in the epiretinal and the central vireous (using donor cadaver eyes). Additionally the features of epiretinal vitreous and ILM were studied.

Results:

Particles with dimensions bigger than 1 micrometer prevailed in all brands of studied suspensions. In human vitreous there were both holes 0.5 micrometer (um) and smaller and holes up to 30 um in diameter. Vitreous body on the surface of the retina had holes 1 um in diameter and smaller. During experiment, after vitreous removal from the retina surface some residual vitreous with holes less than 1 um in size remained on the ILM surface. This allows theoretically staining of these vitreous remains and thus ILM staining.

Conclusions:

Corticosteroid suspension with majority of particles being 1 um or less in size can be advised for vitreous staining during surgery. ILM can be stained with corticosteroid suspension with particles smaller than 1 um (due to remains of residual vitreous). In clinical practice optimized corticosteroid suspension with particles diameter less than 1 um allowed staining of bulk vitreous in vitreous cavity visualizing anatomic structure of vitreous (premacular bursa, cisterns), cortical vitreous, dense epiretinal membranes and ILM.

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