An Impossible Viewpoint

One might argue that the operating microscope is all that is required for monitoring vitreo-retinal surgery. However, the benefits of endoscopy are most apparent when anterior segment conditions do not permit a posterior view or when attempting to target anatomy that is difficult or impossible to see, even under optimal conditions. Specifically, the locations of the peripheral retina, pars plana, ciliary bodies, the sulcus, and posterior iris regions make visualization difficult if not impossible without direct imaging.

Endoscopy permits imaging, illumination, and laser application when:

1. Anterior or posterior conditions preclude a posterior view. Examples of these conditions are:

    - Opaque Cornea

    - Opaque Anterior Chamber

    - Small Pupil

    - Opacified Lens

    - Disrupted Lens Implant

    - Gas in Vitreous

2. Viewing anatomy or pathology is not visible through the operating microscope.

    - Posterior Iris

    - Ciliary Body

    - Pars Plana

    - Peripheral Retina

    - Intraocular Foreign Body

    - Dislocated Lens Implants

    - Angle (for Goniotomy)

Endoscopy facilitates retinal procedures when conditions, like an opaque cornea preclude viewing thought the surgical microscope.

Endoscopic Removal of Dislocated Soemmering

Endophthalmitis; Streptococcus; Dehiscecne PK

Other advantages of endoscopy

- Wide field viewing from within the eye, 23g and 120°

- Integrated laser application to difficult to access areas

- Good for teaching! “Heads-up” Surgery!


Clinical Studies

  • Yu-Fang Huang, Chia-Jen Chang. Endoscope-assisted vitrectomy in the management of retinal detachment with corneal opacity. Taiwan J Opthalmology 2017 Jul-Sep; 7(3): 164-167.
  • Rajeev R., Reddy Pappuru, et. al. Role of Diagnostic Endoscopy in Posterior Segment Evaluation for Definitive Prognostication in Eyes with Corneal Opacification. AJO, 2017. Vol. 176:9-14.
  • Seemant Raizada, Jamal Al Kandari, Khalid Al Sabti. Ophthalmic endoscope: A novel diagnostic imaging tool. Int. Journal of Diagnostic Imaging. 2017, Vol 4. No.2.
  • Wong, S.C., Lee, T.C., Heier, J.S., Ho, A.C., Endoscopic Vitrectomy. Current Opinion in Ophthalmology 2014, 25:195-206.