Tissue Attraction Associated With 20-Gauge, 23-Gauge, and Enhanced 25-Gauge Dual-Pneumatic Vitrectomy Probes

Dugel, Pravin U.; Zhou, Jianbo; Abulon, Dina Joy K.; Buboltz, David C.

doi:10.1097/iae.0b013e3182456f4d

Cited by 39 publications

(18 citation statements)

References 17 publications

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“…Further studies are required to analyse thoroughly and consistently the efficacy of this new technology, adding studies on tissue attraction [21] or fluidic perturbation around the different probes [22]. …”

Section: Discussionmentioning

confidence: 99%

Performance analysis of a new hypersonic vitrector system

et al. 2017

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PurposeTo evaluate porcine vitreous flow and water flow rates in a new prototype hypersonic vitrectomy system compared to currently available pneumatic guillotine vitrectors (GVs) systems.MethodsTwo vitrectors were tested, a prototype, ultrasound-powered, hypersonic vitrector (HV) and a GV. Porcine vitreous was obtained within 12 to 24 h of sacrifice and kept at 4°C. A vial of vitreous or water was placed on a precision balance and its weight measured before and after the use of each vitrector. Test parameters included changes in aspiration levels, vitrector gauge, cut rates for GVs, % ultrasound (US) power for HVs, and port size for HVs. Data was analysed using linear regression and t-tests.ResultsThere was no difference in the total average mean water flow between the 25-gauge GV and the 25-gauge HV (t-test: P = 0.363); however, 25-gauge GV was superior (t-test: P < 0.001) in vitreous flow. The 23-gauge GV was only more efficient in water and vitreous removal than 23-gauge HV needle-1 (Port 0.0055) (t-test: P < 0.001). For HV, wall thickness and gauge had no effect on flow rates. Water and vitreous flows showed a direct correlation with increasing aspiration levels and % US power (p<0.05).ConclusionsThe HV produced consistent water and vitreous flow rates across the range of US power and aspiration levels tested. Hypersonic vitrectomy may be a promising new alternative to the currently available guillotine-based technologies.

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Section: Discussionmentioning

confidence: 99%

Performance analysis of a new hypersonic vitrector system

et al. 2017

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“…However, as the gauge size reduces, the sphere of influence of fluid flow around the port also reduces [14]. The effect of the vitrectomy probe-induced fluid flow is therefore more localized in smaller gauges meaning that it exerts less traction on distant tissue and, with the smaller port size, is more exact when carrying out cutter dissection.…”

Section: Discussionmentioning

confidence: 99%

“…Although commonly grouped together, there are multiple differences between 23g and 25g systems including sclerostomy size, instrument stiffness and utility, as well as fluidic capabilities and tissue attraction [3,14]. A comparison of small-gauge systems is now of particular relevance given that 27-gauge (27g) systems are becoming available [15].…”

Section: Introductionmentioning

confidence: 99%

23-Gauge versus 25-Gauge Vitrectomy for Proliferative Diabetic Retinopathy: A Comparison of Surgical Outcomes

2014

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Purpose: This study compared clinical outcomes and complications between 23-gauge (23g) and 25-gauge (25g) transconjunctival sutureless vitrectomy in patients with proliferative diabetic retinopathy. Study Design: It was a retrospective study using data prospectively defined and collected. 80 eyes underwent 23g transconjunctival sutureless vitrectomy, and 80 eyes underwent 25g surgery using the same vitrectomy system by one surgeon. Primary outcome measures were best-corrected visual acuity, intraocular pressure (IOP), and incidence of intraoperative and postoperative complications. Results: Vision was significantly improved after intervention in both groups (p ≥ 0.0001). There was no significant difference in visual outcomes between the groups (p = 0.43) or in the type and frequency of retinal breaks occurring during surgery (p = 0.63). The 23g group had significantly more patients with a day 1 IOP of <6 mm Hg (p = 0.034) and significantly more patients requiring a sclerostomy suture postoperatively (p = 0.014). Conclusion and Message: Both gauges are equally effective for the treatment of proliferative diabetic retinopathy.

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“…The ports of 23G, 25G, and 27G cutters are also significantly closer to the tip of the probe compared with 20G cutters [18]. Smaller 25G and 27G cutters, with port openings close to the tip, can get extremely close to the retina with smaller sphere of influence on surrounding tissue [48]. This not only enhances safety during vitreous shaving over mobile retina but also can allow the cutter to serve as a dissection tool by enabling access to the very narrow tissue planes during membrane dissection in diabetic tractional detachments [49].…”

Section: Fluidics Of Vitrectomymentioning

confidence: 99%

Review of Small Gauge Vitrectomy: Progress and Innovations

Mohamed

Claes

Tsang

2017

Journal of Ophthalmology

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Purpose. To summarise the surgical advances and evolution of small gauge vitrectomy and discuss its principles and application in modern vitreoretinal surgery. The advent of microincisional vitrectomy systems (MIVS) has created a paradigm shift away from twenty-gauge vitrectomy systems, which have been the gold standard in the surgical management of vitreoretinal diseases for over thirty years. Advances in biomedical engineering and surgical techniques have overcome the technical hurdles of shifting to smaller gauge instrumentation and sutureless surgery, improving surgical capabilities and expanding the indications for MIVS.

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Tissue Attraction Associated With 20-Gauge, 23-Gauge, and Enhanced 25-Gauge Dual-Pneumatic Vitrectomy Probes

Abstract: The sphere of influence on surrounding tissue was greatest with large-gauge vitrectomy probes. This laboratory model indicated that small-gauge probes could be used to target specific tissues while minimizing the effects on adjacent tissue structures.

Cited by 39 publications

References 17 publications

Performance analysis of a new hypersonic vitrector system

Performance analysis of a new hypersonic vitrector system

23-Gauge versus 25-Gauge Vitrectomy for Proliferative Diabetic Retinopathy: A Comparison of Surgical Outcomes

Review of Small Gauge Vitrectomy: Progress and Innovations

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