Innovative Technologies in Pars Plana Vitrectomy - Minimally Invasive Vitrectomy System

Abstract

Minimally Invasive Vitrectomy System is a concept that was developed during the past years with the goal to make pars plana vitrectomy a safer and a less traumatizing procedure. The development of small gauge vitrectomy systems has led to the decrease of tissue damage and the shortening of the operating time. Although MIVS is increasingly popular, its use varies substantially according to the personal experience of each vitreo-retinal surgeon. The transition from the 20 gauge to the small gauge vitrectomy (23G, 25G) is directly related to the global approach to vitrectomy regarding incision making, intraoperative fluidics, cutting technology, illumination and accessory instruments. The development of new instruments capable to overcome the size and lumen handicaps became necessary. The use of small gauge instruments has various consequences on the vitrectomy itself: the modification of fluidics during surgery, the decrease of illumination, the need of fewer accessory and multi-function instruments. For the past 12 months, we used 25+ vitrectomy system sustained by the Constellation platform, in 296 cases that required vitreo-retinal surgery. The clinical conditions were the following ones: rhegmatogenous retinal detachments (120 cases - 40.54%), vitreous haemorrhages (100 cases - 33.78%), tractional retinal detachments (35 cases - 11.82%), epimacular membranes (15 cases - 5.06%), nucleus/lens luxated into the vitreous cavity (11 cases - 3.71%), intraocular foreign bodies (6 cases - 2.02%), macular holes (5 cases - 1.68%), endophthalmitis (4 cases - 1.35%). In this paper, the personal experience of using MIVS in variate cases that required vitreo-retinal surgery is illustrated.