June 5, 2020 Conference


Novel surgical device to allow precise localization and safe drainage of subretinal fluid during scleral buckling surgery

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Kevin Ma (Presenter)
Wen Hu, Massachusetts Eye and Ear
Jan Kylstra
Purpose: Drainage of subretinal fluid is an important step of scleral buckling surgery in the repair of rhegmatogenous retinal detachments. External needle drainage under indirect ophthalmoscopy is a useful technique to achieve drainage of subretinal fluid. However, this method can be challenging due to the difficulty in determining the exact needle position and entry site. Methods: We present a novel surgical device to allow for safer and faster drainage of subretinal fluid during scleral buckling surgery. Results: The novel device features a blunt scleral depressor tip from which a drainage needle can be manually advanced. While the operator is directly examining the retina, the blunt tip is first used to perform scleral depression externally, allowing for precise localization of the desired drainage site. Once the desired location is identified, the spring-loaded needle can be advanced in a controlled fashion, which then pierces the wall of the globe and allows the subretinal fluid to passively egress. The rate of fluid egress can be titrated via the occlusion of a connecting channel from the lumen of the syringe using the index finger. Conclusion: The device allows for precise identification and placement of the needle insertion site under direct visualization of the retina, controlled drainage of fluid while the intraocular pressure is maintained, and assessment of the adequacy of drainage in real time.
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