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LETTER TO EDITOR
Year : 2006  |  Volume : 54  |  Issue : 1  |  Page : 66-67

A simple technique to fixate the bullet pipe and perform bimanual vitreous surgery.


Ranjini Eye Care, Near Powerhouse, Vyttila, Cochin - 682019, Kerala, India

Correspondence Address:
Biju Raju
Ranjini Eye Care, Near Powerhouse, Vyttila, Cochin - 682019, Kerala
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0301-4738.21626

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How to cite this article:
Raju B, Raju N S, Raju AS. A simple technique to fixate the bullet pipe and perform bimanual vitreous surgery. Indian J Ophthalmol 2006;54:66-7

How to cite this URL:
Raju B, Raju N S, Raju AS. A simple technique to fixate the bullet pipe and perform bimanual vitreous surgery. Indian J Ophthalmol [serial online] 2006 [cited 2019 Oct 22];54:66-7. Available from: http://www.ijo.in/text.asp?2006/54/1/66/21626

Dear Editor,

We read with interest the article "A simple technique to fixate the bullet pipe and perform bimanual vitreous surgery" by Schmidt et al .[1] The authors have done a commendable job in introducing a new way of performing bimanual vitrectomy. We would like to make few comments on bimanual vitrectomy.

The technique described by the authors requires a fourth port and has limitations as addressed by the authors. We have been doing bimanual vitrectomy for the last 1 year using an illumination infusion cannula (Alcon Laboratories, Texas) designed by Stanley Chang, MD. The cannula is a 4mm infusion cannula with a bullet light source [Figure - 1]a. The infusion cannula is sutured to the inferotemporal sclerotomy which offers excellent stability.

The nasal part of the retina is relatively more difficult to access during vitrectomy due to the nasal bridge and the brow. Having an additional port in the nasal side will further compromise the surgical procedure. Rotation of the globe becomes difficult when there is a light pipe secured inferonasally. The dual mode cannula overcomes the above limitations. As an infusion cannula is an absolute requisite for vitreoretinal surgery, using this cannula does not necessitate a change from the current technique. The illumination source is a wide angle bullet, which uniformly illuminates the fundus unlike the older illumination-infusion cannulas.

The illumination offered by this cannula was bright enough to perform procedures like bimanual membrane dissection [Figure - 1]c and peripheral vitrectomy or endophoto-coagulation with simultaneous scleral depression [Figure - 1]d and e. Occasionally the shadow of the instrument in the superotemporal port falls in the field of view. However this did not impair the visualization.

 
  References Top

1.
Schmidt JC, Rodrigues EB, Meyer CH. A simple technique to fixate the bullet pipe and perform bimanual vitreous surgery. Indian J Ophthalmol 2004;52:337-8.  Back to cited text no. 1
    


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