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August 1988

Protection From Operating Microscope-Induced Retinal Phototoxicity During Pars Plana Vitrectomy

Arch Ophthalmol. 1988;106(8):1032. doi:10.1001/archopht.1988.01060140184010

To the Editor.  —In the April 1988 issue of the Archives, McDonald and Harris1 reported two cases of operating microscope-induced retinal phototoxicity during pars plana vitrectomy. The authors recommend that vitrectomy surgeons use a corneal light shield or intramicroscope beam shield (eclipse filter) during wound closure, "especially in cases where there is clear media, the retina is attached, and a pseudophakic or natural crystalline lens is present." The authors theorize that the phototoxic lesions occur primarily at the end of the vitrectomy procedure when the sclerotomies are being closed using the coaxial illumination from the operating microscope.Although a corneal light shield or an eclipse filter are satisfactory methods of protecting the retina from operating microscope—induced retinal injury, there are additional protective measures that can be utilized. Overhead mobile surgical lights can be employed for illumination of the operative field during the initial preparation for vitrectomy surgery as well

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