Eye
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Intraoperative imaging is a desirable tool in oculoplastic surgery; however, there are few modalities which allow surgeons to capture and edit the images in real time without compromising the sterility of the surgical field. We describe the set-up of the VITOM® exoscope system based on our 5 years' experience of using it as an effective intraoperative video imaging and teaching modality for extraocular surgery. ⋯ Our experience showed that the VITOM® exoscope is an excellent intraoperative video imaging and teaching aid, as it allows real-time capture and editing of open surgery and seems to improve theatre flow. With newer models using 3D stereoscopic vision, it could be further evaluated as a heads-up viewing system within extraocular and oculoplastic surgery.
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Randomized Controlled Trial
Lacrimal dilator-facilitated incisionless vs. standard sub-Tenon's block: a randomized, prospective and non-inferiority comparative study.
Standard sub-Tenon's block (STB) involves incision (dissection) of conjunctiva and Tenon's capsule with the help of blunt scissors and forceps, insertion of a blunt sub-Tenon's cannula under the Tenon's capsule and injection of local anaesthetic agent. STB is frequently associated with minor complications such as chemosis and postoperative subconjunctival haemorrhage but rare sight and life-threatening complications. To reduce these minor complications, several variations of incisionless STB have been described however, there are no comparative data. One such incisionless STB involves the use of lacrimal dilator which is easily available in the operating theatre. We compared incisionless lacrimal dilator-facilitated with the standard STB for effectiveness, chemosis, and postoperative subconjunctival haemorrhage. ⋯ Incisionless lacrimal dilator-facilitated STB decreases intraoperative chemosis and postoperative conjunctival haemorrhage in comparison to standard STB. Analgesia and akinesia are comparable in both techniques.
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The coronavirus disease 2019 (COVID-19) pandemic has imposed measures of social distancing and barriers in delivery of "in person" education. Institutions, involved in training the next generation of ophthalmologists, are using alternative teaching methods to maintain the standard of education. ⋯ COVID-19 pandemic imposed great challenges in the educational field of Ophthalmology. The experience related to virtual training in Ophthalmology, gained during the pandemic, may change the traditional teaching practices in the world and provide new educational opportunities.
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Sub-Tenon's block (STB) is a good technique of local anaesthesia for many types of eye surgery. It has a relatively good risk profile, in that sight- and life-threatening complications appear to be extremely rare. ⋯ Usage of STB varies significantly across the globe. This narrative review documents the historical evolution of STB techniques, anatomical and physiological considerations, its utility and suitability, complications, explores the current practice and possible future applications.