Abstract
ObjectiveTo report the clinical outcomes of a 25-gauge, beveled-tip, 10,000 cuts-per-minute (cpm) microincisional vitrectomy surgery (MIVS) system.MethodsProspective case series of eyes undergoing primary pars plana vitrectomy (PPV) for common vitreoretinal indications. Main outcome measures were: rate of achieving surgical objectives, operative times, number of surgical steps, use of ancillary instruments, corrected distance visual acuity (CDVA), and adverse events (AE).ResultsThe surgical objectives were achieved in all eyes. Mean total operative time (TOT), core, shave and total vitrectomy times were 1891 ± 890, 204 ± 120, 330 ± 320, 534 ± 389 s, respectively. Mean number of surgical steps was 4.3 ± 1.5. Mean number of ancillary instruments used was 4.5 ± 1.9. Mean CDVA improved by 0.53 ± 0.56 logMAR units (P < 0.001) 3 months postoperatively. AE included elevated IOP (8%), hypotony (6%), and re-detachment (2%). Majority (82%) had no postoperative discomfort. The number of surgical steps demonstrated a positive correlation with TOT (p < 0.05), number of ancillary instruments used (p < 0.05), and postoperative Day 1 IOP (p < 0.05). The number of times ancillary instrumentation was used demonstrated a positive correlation with TOT (p < 0.05).ConclusionBeveled-tip, 10,000 cpm MIVS system effectively and safely performs common VR procedures of varying complexity and may reduce operative times and use of ancillary instrumentation.
Highlights
In the 1970’s, Robert Machemer performed the first closed-system, pars plana vitrectomy (PPV) using a single-port, 17-gauge (17G) system with a maximal cut rate of 400 cuts per minute [1]
The efficacy, efficiency and safety of PPV has improved with the introduction of microincisional vitrectomy surgery (MIVS), wide-angle viewing as well as new surgical techniques such as membrane dissection, internal subretinal fluid
The number of surgical steps demonstrated a positive correlation with total operative time (TOT) (p < 0.05), number of ancillary instruments used (p < 0.05), and postoperative Day 1 intraocular pressure (IOP)
Summary
In the 1970’s, Robert Machemer performed the first closed-system, pars plana vitrectomy (PPV) using a single-port, 17-gauge (17G) system with a maximal cut rate of 400 cuts per minute (cpm) [1]. Faster cut rates and fluidics control have increased PPV precision, decreased operative times, hastened postoperative recovery and reduced postoperative pain and complications [6, 7]. There are few publications describing the clinical use of this relatively novel cutter probe configuration; fewer still are publications that report on the multifunctional capabilities of cutter probes and how they might potentially enhance efficiency by reducing the usage of mmons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. The purpose of this study was to describe the clinical outcomes and assess the utility of using a 25-gauge (25G), 10,000 cpm BTCP for the treatment of various vitreoretinal (VR) diseases
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