The Retinal Irradiance and Spectral Properties of the Multiport Illumination System for Vitreous Surgery

Surgeon-controlled–endoillumination-guided irrigation and aspiration during combined 23-gauge sutureless vitrectomy and cataract surgery in eyes with poor fundus reflex

“…First, use of endoillumination is associated with an increased risk for retinal phototoxicity in eyes having cataract surgery. 9,10 Because the distance between the light source and the posterior pole is much longer than 3.0 to 7.0 mm during conventional vitrectomy, the risk for phototoxicity may be minimal. Furthermore, the risk is almost absent, especially Moreover, compared with a noncannulated vitrectomy system, there is a trend toward lower rates of sclerotomy-related retinal breaks with a cannulated vitrectomy system.…”

One-port pars plana vitrectomy (by 25-G micro-incision)

“…Indeed, it is common knowledge that operating microscope [23] and endoilluminator lights [24][25][26][27][28][29][30][31] can damage the retina (photic retinopathy). Skull structures such as eyebrow, and ocular ones such as eyelid, cornea, pupil and crystalline lens work as defensive barriers against the damaging light, ultimately protecting the retina.…”

“…A great deal of damaging irradiation would be then stopped from harming the macula. In contrast, the endoilluminator of the TPPPV illumination system holds the light source into the eye very close to the retina (and to the macula in macular surgery), thus bypassing the "lines of defence", and exposing the retina to dangerous irradiance levels [28,29]. It has been estimated that 7,200 lumen are provided by the slit focused on the macula vs 135,000 lumen by intraocular fibre at 4 mm from the macula (Ducournau D.: unpublished data).…”

A Review of Microinvasive Combined Phaco-Vitrectomy: Recent Technical Advances

“…On the other hand, the maximum exposure time, the maximum power densities and its spectral distribution have to be taken into account to reduce retinal damage. Conventional xenon light sources exhibit intensive emission in the blue part of their spectrum that is responsible for the photochemical harm of these light sources, whereas almost all wavelengths in the visible spectrum contribute to thermal damage [15]. The recent advances in LED technology have resulted in the development of light sources which reach a brightness comparable to that of xenon or mercury light sources but which have eliminated or reduced those damaging components of the spectrum, thereby reducing the photochemical and thermal hazards.…”