Lamina puncture: pars plana optic disc surgery for central retinal vein occlusion.
OBJECTIVE
To determine the feasibility of creating a perivascular space adjacent to the central retinal vein at the level of the lamina cribrosa as a potential method of reestablishing perfusion in central retinal vein occlusion.


METHODS
Various designs for a puncture instrument, or lamina puncture lancet, were investigated in cadavers, pigs that had undergone enucleation, and in vivo rabbit eyes.


RESULTS
A lancet with a sharp cutting edge on one side and an opposing blunt edge is repeatedly able to create a perivascular space with limited optic nerve fiber damage.


CONCLUSIONS
Lamina puncture is technically feasible, and evaluation in carefully selected patients appears warranted.
Lit
Eugene S
ES
Massachusetts Eye & Ear Infirmary, 243 Charles St, Boston, MA 02114, USA.
Tsilimbaris
Miltiadis
M
Gotzaridis
Eustratios
E
D'Amico
Donald J
DJ
D000818:Animals; D005240:Feasibility Studies; D006801:Humans; D013508:Ophthalmologic Surgical Procedures; D009898:Optic Disk / Q000473:pathology / Q000601:surgery*; D011677:Punctures / Q000295:instrumentation / Q000379:methods*; D011817:Rabbits; D012170:Retinal Vein Occlusion / Q000601:surgery*; D013552:Swine