A study of surgical approaches to retinal vascular occlusions.
OBJECTIVE
To develop a surgical approach to retinal vascular occlusive diseases.


METHODS
Surgical manipulations were performed on the retinal vasculature to explore the feasibility of retinal vascular surgery. In a human cadaver eye model (25 procedures, 21 eyes), we performed (1) cannulations of retinal blood vessels with a flexible stylet and (2) arteriovenous sheathotomies. Histological findings were correlated with surgical outcomes. In an in vivo model (6 eyes, 5 animals), we examined the technical feasibility and anatomical outcome of surgical penetration of retinal blood vessels.


RESULTS
Cannulations of branch retinal arterioles were successful in 7 of 9 procedures, cannulations of branch retinal venules were successful in 1 of 3 procedures, cannulations of central retinal arteries were successful in 0 of 2 procedures, and cannulations of central retinal veins were successful in 2 of 4 procedures. Arteriovenous sheathotomies were successful in 4 of 7 procedures. In the in vivo model, surgical penetration of retinal blood vessels was accomplished in 5 of 6 eyes. Immediately postoperatively, thrombus formation with obstruction of the retinal vasculature was observed. At 2 weeks postoperatively, the retinal vasculature was completely patent.


CONCLUSIONS
Multiple surgical techniques aimed at assisting recanalization of occluded retinal vasculature have been evaluated. Retinal vascular surgery has become more feasible and deserves further investigation.
Tang
W M
WM
Department of Ophthalmology, Boston University School of Medicine, Mass, USA. wtang@bu.edu
Han
D P
DP
D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D002102:Cadaver; D002404:Catheterization / Q000379:methods; D004285:Dogs; D006801:Humans; D008875:Middle Aged; D013508:Ophthalmologic Surgical Procedures; D011817:Rabbits; D015356:Retinal Artery Occlusion / Q000473:pathology / Q000601:surgery*; D012170:Retinal Vein Occlusion / Q000473:pathology / Q000601:surgery*; D012171:Retinal Vessels / Q000601:surgery