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Pars Plana Optic Disc Surgery for Central Retinal Vein Occlusion

Eugene S. Lit, MD; Miltiadis Tsilimbaris, MD; Eustratios Gotzaridis, MD; Donald J. D'Amico, MD

Arch Ophthalmol. 2002;120:495-499.

Objective  To determine the feasibility of creating a perivascular space adjacent to the central retinal vein at the level of the lamina cribrosa as a potential method of reestablishing perfusion in central retinal vein occlusion.

Methods  Various designs for a puncture instrument, or lamina puncture lancet, were investigated in cadavers, pigs that had undergone enucleation, and in vivo rabbit eyes.

Results  A lancet with a sharp cutting edge on one side and an opposing blunt edge is repeatedly able to create a perivascular space with limited optic nerve fiber damage.

Conclusions  Lamina puncture is technically feasible, and evaluation in carefully selected patients appears warranted.

From the Retina Service of the Massachusetts Eye & Ear Infirmary and the Department of Ophthalmology, Harvard Medical School, Boston, Mass.

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