Abstract
ObjectivesThe objective of this study is to compare various dual blade vitrectomy cutters for their efficiency in an in vitro setting.MethodsIn this in vitro experimental study, we compared various vitrectomy systems including EVA (Dutch Ophthalmic Research Center, Zuidland, The Netherlands), REVOLUTION (Optikon 2000, Inc., Rome, Italy), and OS4 (Oertli Instrumente AG, Berneck, Switzerland) in terms of efficiency in vitreous cutting and aspiration for various vitreous substitutes. These substitutes included water, chicken egg albumin, and goat vitreous. We only used 23-gauge dual blade cutters across all platforms to maintain uniformity. The cutting and aspiration efficiency was measured across various cut and vacuum settings of vitrectomy machines and measured as mass aspirated in a given time. Data analysis included comparing the amount of mass aspirated by these machines at preset cut and vacuum settings.ResultsScatter plots showed a comparable mass of water aspirated by the EVA and REVOLUTION at 1000 to 5000 cuts per minute at a constant vacuum of 500 mm Hg whereas OS4 aspirated lesser mass at similar settings. Same trends were noted for goat vitreous for EVA and REVOLUTION but aspirated mass of albumin fluctuated widely across various platforms. At peak machine settings, REVOLUTION showed superiority across all three vitreous models due to its higher peak settings. The area under curve (AUC) analysis showed no significant differences among machines for water and goat vitreous at comparable settings but results were fluctuating for egg albumin.ConclusionEmploying higher cut rates for dual blade cutters results in better efficiency of vitrectomy machines.
Highlights
Ophthalmologists have been striving for new ideas of vitreous removal through a small opening without incurring much trauma to surrounding structures for more than four decades
Same trends were noted for goat vitreous for EVA and REVOLUTION but aspirated mass of albumin fluctuated widely across various platforms
The area under curve (AUC) analysis showed no significant differences among machines for water and goat vitreous at comparable settings but results were fluctuating for egg albumin
Summary
Ophthalmologists have been striving for new ideas of vitreous removal through a small opening without incurring much trauma to surrounding structures for more than four decades now. The initial humble beginnings were by Robert Machemer in 1971 when he introduced a vitreous cutter driven through a small electric motor mounted on a syringe with a needle [1]. This multifunction (cut, infusion, aspiration) vitreous cutter was 17-gauge with a diameter of 1.42 mm and utilized a 2.3 mm scleral opening [2]. The mechanism of action is through vitreous liquefaction rather than vitreous cutting, thereby eliminating potential vitreous turbulence and retinal traction This technique is not in widespread use at the moment [6]
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