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    New hypersonic vitrector introduces concept of ‘vitreous liquefaction’

     

    Dependent on vacuum, flow

    In their previous research, Dr. Stanga found that guillotine-cutter performance was dependent on cut-rate, vacuum, and gauge, both in water and vitreous. The hypersonic vitrector was dependent on vacuum and flow for both fluids and ultrasonic power for vitreous flow.

    “The hypersonic vitrectomy technology allows for the use of a smaller gauge and port size, as well as lower infusion pressures than with a guillotine vitrector,” he said.

    Microscopic findings when operating close to the retina were similar with both types of vitrectors when comparing the nasal macula and the temporal one that was used as a control.  In a study of live porcine eyes, the microscopic findings were again nonspecific. A study of delayed finding 30-days post vitrectomy in live porcine eyes did not show abnormal findings on indirect ophthalmoscopy with nonspecific microscopic findings.

    Using electron microscopy, fragmentation at 3,000 to 5,000 cuts a minute was seen, but it was significantly higher with the hypersonic vitrector.

    “This is the first ever histopathology report of both the vitreous and the retina after the use of any type of vitrector,” Dr. Stanga said. “The hypersonic vitrector ‘liquefies’ the vitreous and hence modifies its viscosity. We are introducing the new concept of ‘vitreous liquefaction’.”

    Dr. Stanga concluded that the 23-gauge hypersonic vitrector is as efficient as the 23-gauge guillotine vitrector.

    “Hypersonic vitrectomy is a new technology with allows for smaller gauge with flow rate similar to that of the guillotine-based one,” Dr. Stanga. “It effectively induces vitreous liquefaction. We can, for the first time, remove vitreous, silicone oil, and soft lens matter with the same probe.”

     

    Paulo E. Stanga, MD

    E: [email protected]

    E: [email protected]

    This article was adapted from information about the system that Dr. Stanga presented at Retina Subspecialty Day held prior to the 2016 American Academy of Ophthalmology. Dr. Stanga is a consultant for Bausch + Lomb.

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