The minimally invasive vitrectomy or MIVs using the 27 gauge is the latest in the field of retinal and macula surgery. It seems to be the future for any surgery on the retina. Introduced on an experimental basis in 2010 by a Japanese surgeon, Oshima, it has been used by us since 2011. We were among the first few in Europe, contributing to the development and spreading awareness about this method.
We were invited to perform a live surgery combining a retinal surgery with a minimally invasive 27 gauge technique in SOI International Congress held in Milan in 2012. Following this was a direct intervention in the macular pucker to Congress of the Italian Society of Surgery Vitreoretinal (GIVRE) in 2013. Then an intervention of diabetic retinopathy and emovitreo at the International Congress of Ancona took place. In 2014, Dr. Claudio conducted a course as a lecturer about minimally invasive 27 gauge progress on the proliferative diabetic retinopathy surgery during the EURETINA EUROPEAN CONGRESS. In 2015 in Nice in France , he combined cataract and macular pucker, during the International Congress the Italian Society of Surgery Vitreoretinal (GIVRE) in 2016 in Trieste.
It consists of further reduction of the gauges of the tools and, of the access holes within the eye, which range from 500 to 400 microns in diameter. It may seem like a small difference, but it is instead a reduction of 20% and this causes the difficulties for the surgeon to increase exponentially. For the patient, there is an increase in benefits in terms of safety and reduction of chances of inflammation post operation, with a more rapid recovery of normal activities.
A few months began to be marketed in Italy and we are one of the very few public ophthalmology centers to use it routinely, having developed experience from 2011.
It consists of three very small incisions, the size of an insulin needle (400 microns), made in the sclera or the white part of the eye (sclera). Within these flow micropinze, microforbici, light fibers and a tool cuts alongs the vitreous. This microprobe allows the removal of the vitreous (vitrectomy). Very carefully any remaining vitreous traction on the macula is eliminated. With a microscopic clamp the membrane is then "peeled" (peeling) from the retina, after staining of the same to increase their visibility.
Increased level of comfort for patient
- Time taken for a surgery is reduced
- Less tissue trauma
- More rapid visual recovery
- Reduced inflammation and no pain in the post-operatorio.12
- Sutureless → Power of the conjunctiva