Blind World

Tiny funnel-shaped plastic devices give surgeon easier access to the inside of the eye.

September 16, 2002.

By Natalie Soh,
The Straits Times (Singapore).

A SINGAPORE surgeon has become the first doctor in South-east Asia to use a new technology in eye operations.

At the heart of this breakthrough are tiny plastic devices, called 'trocars', that help surgeons access the inside and back of the eye easier, causing less trauma to the patient.

According to Dr Caroline Chee, head of Medical Retina Services with The National Healthcare Group's The Eye Institute, patients generally recovered better, with less irritation to the eye, with the new technique. The trocar looks very much like a miniature funnel, with a wider top and a hollow tube below. A needle is threaded through the structure, which is less than an inch long, and it helps pierce the outer layers of the eye.

When in place, the needle is removed, the trocar remains behind: Then the surgical instruments are threaded through the funnel into the eye.

In the one month that it has been in Singapore, six patients in the National University Hospital have undergone surgery with the new technique.

Dr Chee explained that many diseases could affect the retina, or the vitreous humour - the gel-like substance that fills the cavity between the retina and the lens.

She said: 'When we have to go in and repair the back of the eye, the usual procedure is to cut open the conjunctiva - or the loosely bound 'skin' which covers the surface of the eye.'

Then, surgeons make more cuts in the next layer - the sclera, or the tough white wall of the eye - to pass through instruments that go into the inside of the eye.

A tube has to be sutured onto the eye to keep infusing liquid, so the eye does not collapse during surgery.

And at the end of the surgery, the layers have to be stitched up. In some cases, it can cause scarring.

'There's also more discomfort because of the stitches, and there's usually some swelling and redness.'

With the new technology, these side effects are less- ened.

And because these trocars and their puncture wounds are so small, the wounds heal by themselves, without the need for stitches.

'Generally, it means less time in the operating theatre, and cost savings to both the patients and the hospital.'

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