MIYAKE ANALYSIS OF ANTERIOR VITRECTOMY TECHNIQUES

Purpose: To study the efficacy and safety of anterior vitrectomy with the Miyake system. Setting. Miyake Laboratory, IOLAB, Claremont, Calif ornia. Methods: Four pig eyes and three human eyes were transected equ atorially. The anterior segments were glued to a glass slide and place d on a stage for anterior and posterior videography. Phacoemulsificati on was performed, and the posterior capsule was intentionally ruptured . Three different vitrectomy techniques were studied: anterior vitrect omy with coaxial infusion sleeve, anterior vitrectomy with separate li mbal infusion, and pars plana vitrectomy with limbal infusion. Results : All techniques showed that vitreous could be safely and effectively removed without undue stress on the retina whenever the vitrectomy ins trument was held directly beneath the iris and not placed peripherally to the iris root. Only the pars plana site allowed access to the enti re posterior aspect of the iris for removal of vitreous gel. Conclusio n: Anterior vitrectomy can be performed safely and effectively with an y of the three approaches studied. The pars plana technique permitted removal of gel beneath the superior iris. This has important clinical implications because irido-vitreous adhesions tend to form superiorly after limbal vitrectomy.