Glyxambi
Home About us Editorial board Ahead of print Current issue Search Archives Submit article Instructions Subscribe Contacts Login 
  • Users Online: 597
  • Home
  • Print this page
  • Email this page


 
   Table of Contents      
LETTER TO THE EDITOR
Year : 2019  |  Volume : 67  |  Issue : 1  |  Page : 175

Response to comment on: Pars-plana fluid aspiration for positive vitreous cavity pressure in anterior segment surgeries


1 Department of Ophthalmology, Christian Medical College, Vellore, Tamil Nadu, India
2 Fellow in Vitreoretinal Surgery, Narayana Netralaya, Rajaji Nagar, Bangalore, Karnataka, India

Date of Web Publication21-Dec-2018

Correspondence Address:
Dr. Smitha Jasper
Department of Ophthalmology, Christian Medical College (CMC), Schell Campus, Arni Road, Vellore - 632 001, Tamil Nadu
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijo.IJO_1769_18

Rights and Permissions

How to cite this article:
Kuriakose T, Jasper S, Thomas S. Response to comment on: Pars-plana fluid aspiration for positive vitreous cavity pressure in anterior segment surgeries. Indian J Ophthalmol 2019;67:175

How to cite this URL:
Kuriakose T, Jasper S, Thomas S. Response to comment on: Pars-plana fluid aspiration for positive vitreous cavity pressure in anterior segment surgeries. Indian J Ophthalmol [serial online] 2019 [cited 2019 Jan 16];67:175. Available from: http://www.ijo.in/text.asp?2019/67/1/175/248135



Sir,

We thank authors[1] for the interest shown in our article.[2] As the authors have pointed out, squeezing of the lids by the patients during topical anesthesia or inadequate blocks can be a cause of positive vitreous pressure. All our cases were done under peribulbar anesthesia and we had ensured that the blocks were adequate in all cases. It was not specifically mentioned in our article.

Misdirection of infusion fluid causing raised vitreous pressure is only a conjuncture and it is difficult to try and prove it by ultrasound biomicroscopy (UBM) in a patient per-operatively. Though UBM can detect fluid just behind the lens only, the sensitivity and specificity of this test are not known. UBM is not useful for more posterior locations of the fluid. No UBM was done in any of our cases.

As has been pointed out, there is a possibility that liquefied vitreous would have also been aspirated; the point we want to make here is that it is only aqueous/misdirected intraocular irrigation fluid or liquefied vitreous that can be aspirated through a 30-G needle and this will not cause vitreous traction and retinal tears. For the same reason, it is our belief that the complications of this procedure will be similar to intravitreal injection. Incorrect procedure can cause injury to the lens even with MIVS systems. We agree that, theoretically a 27-G MIVS system will be safer than the using of a 30-G needle through the pars plana to decompress the posterior segment. The question is how many anterior segment surgeons especially those in developing countries have such systems in their operation theater and if the cost is worth it when the procedure we described is available at next to no cost to achieve the same objective.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Srirampur A, Kalwad A, Balijepalli P, Katta KR. Comment on: Pars-plana fluid aspiration for positive vitreous cavity pressure in anterior segment surgeries. Indian J Ophthalmol 2019;67:174-5.  Back to cited text no. 1
  [Full text]  
2.
Kuriakose T, Jasper S, Thomas S. Pars-plana fluid aspiration for positive vitreous cavity pressure in anterior segment surgeries. Indian J Ophthalmol 2018;66:565-7.  Back to cited text no. 2
[PUBMED]  [Full text]  




 

Top
 
 
  Search
 
    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
    Access Statistics
    Email Alert *
    Add to My List *
* Registration required (free)  

 
  In this article
References

 Article Access Statistics
    Viewed83    
    Printed0    
    Emailed0    
    PDF Downloaded17    
    Comments [Add]    

Recommend this journal