Background <p>Vitreous biopsy is a common technique used to guide management of acute endophthalmitis and help differentiate between infectious and inflammatory conditions. Currently, in-clinic vitreous biopsy is performed with a 25-gauge needle, without the ability to cut vitreous, potentially leading to reduced diagnostic yield. Recent work demonstrated the ability to perform vitreous biopsy with an off-the-shelf vitreous cutter. However, this was limited by complexity of assembly. Here, a technique using a single peel pack vitrectomy cutter is demonstrated for in-clinic vitreous biopsy.</p> Methods <p>A 25-gauge vitreous cutter is opened from a peel pack. The drive line is identified, cut to length, and attached to a 10 mL syringe. A 1 mL syringe is attached to the aspiration line. After a trocar is used to place a cannula in the pars plana, the vitreous cutter is introduced into the eye. Cutting is performed by an assistant actuating the 10 mL syringe while the surgeon aspirates from the 1 mL syringe. After sample is collected, antimicrobials are injected if required and the cannula is removed.</p> Results <p>A peel pack technique simplifies assembly for an in-clinic vitreous biopsy using a manually actuated cutter.</p> Conclusion <p>We present a novel, improved, and simplified technique for vitreous tap using a vitreous cutter provided in a single peel pack, actuated by a single syringe with minimal assembly prior to use. This technique may be more accessible for clinicians than prior techniques and does not require a surgical console.</p>

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In-clinic vitreous biopsy peel pack technique

  • Charles DeBoer,
  • Cindy Zhao,
  • Prithvi Mruthyunjaya,
  • Vinit B. Mahajan,
  • Karen M. Wai,
  • Steven R. Sanislo

摘要

Background

Vitreous biopsy is a common technique used to guide management of acute endophthalmitis and help differentiate between infectious and inflammatory conditions. Currently, in-clinic vitreous biopsy is performed with a 25-gauge needle, without the ability to cut vitreous, potentially leading to reduced diagnostic yield. Recent work demonstrated the ability to perform vitreous biopsy with an off-the-shelf vitreous cutter. However, this was limited by complexity of assembly. Here, a technique using a single peel pack vitrectomy cutter is demonstrated for in-clinic vitreous biopsy.

Methods

A 25-gauge vitreous cutter is opened from a peel pack. The drive line is identified, cut to length, and attached to a 10 mL syringe. A 1 mL syringe is attached to the aspiration line. After a trocar is used to place a cannula in the pars plana, the vitreous cutter is introduced into the eye. Cutting is performed by an assistant actuating the 10 mL syringe while the surgeon aspirates from the 1 mL syringe. After sample is collected, antimicrobials are injected if required and the cannula is removed.

Results

A peel pack technique simplifies assembly for an in-clinic vitreous biopsy using a manually actuated cutter.

Conclusion

We present a novel, improved, and simplified technique for vitreous tap using a vitreous cutter provided in a single peel pack, actuated by a single syringe with minimal assembly prior to use. This technique may be more accessible for clinicians than prior techniques and does not require a surgical console.