Limbal versus Pars Plana Vitrectomy – Which is Superior?
August 23, 2009
We all lose vitreous sooner or later. I have become convinced that a limbal based virectomy is inferior to pars plana approach. It really isn’t that hard to take down the conjunctiva, insert an MVR blade 3.5 mm behind the limbus, and do the vitrectomy from there (separate the infusion and use an AC maintainer or just hold it in your paracentesis incision). I think the vitrectomy will be shorter and the odds of vitreous to the wound is reduced. Squirt in a little Kenalog, and you’ll see clearly what’s going on- and a little Kenalog left in the eye can only help in a vitrectomy anyway. I think what stops most of us from switching is our inertia, and we want to avoid the time spent going through the pars plana. But it only adds 5 minutes, and I think our patients will do better. Be sure to do a dilated exam the next day.
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