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A Study of Surgical Approaches to Retinal Vascular Occlusions
William M. Tang, MD;
Dennis P. Han, MD
Arch Ophthalmol. 2000;118:138-143.
Objective To develop a surgical approach to retinal vascular occlusive diseases.
Methods Surgical manipulations were performed on the retinal vasculature to explore the feasibility of retinal vascular surgery. In a human cadaver eye model (25 procedures, 21 eyes), we performed (1) cannulations of retinal blood vessels with a flexible stylet and (2) arteriovenous sheathotomies. Histological findings were correlated with surgical outcomes. In an in vivo model (6 eyes, 5 animals), we examined the technical feasibility and anatomical outcome of surgical penetration of retinal blood vessels.
Results Cannulations of branch retinal arterioles were successful in 7 of 9 procedures, cannulations of branch retinal venules were successful in 1 of 3 procedures, cannulations of central retinal arteries were successful in 0 of 2 procedures, and cannulations of central retinal veins were successful in 2 of 4 procedures. Arteriovenous sheathotomies were successful in 4 of 7 procedures. In the in vivo model, surgical penetration of retinal blood vessels was accomplished in 5 of 6 eyes. Immediately postoperatively, thrombus formation with obstruction of the retinal vasculature was observed. At 2 weeks postoperatively, the retinal vasculature was completely patent.
Conclusions Multiple surgical techniques aimed at assisting recanalization of occluded retinal vasculature have been evaluated. Retinal vascular surgery has become more feasible and deserves further investigation.
From the Departments of Ophthalmology, Boston University School of Medicine, Boston, Mass (Dr Tang), and Medical College of Wisconsin, Milwaukee (Dr Han). The authors do not have any commercial or proprietary interest in any product or instrument discussed in the article.
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