Vitreous Microsurgery

Abstract

When Robert Machemer, MD, designed his vitreous infusion suction cutter (VISC) in 1970, he was seeking an instrument to replace cellulose sponge vitrectomy popularized by David Kasner, MD. It soon became apparent that trans-pars plana vitrectomy, first used by Machemer to clear chronic vitreous hemorrhage, was a major revolution in posterior segment surgery. "Dr Charles' engineering background elegantly comes through..." The VISC, called a multifunction probe because it combines infusion, suction, cutting, and illumination in one instrument, was subsequently replaced by the O'Malley ocutome, which separated the infusion, endoillumination, and suction-cutting functions of the VISC into trans-pars plana infusion sutured to the sclera, and separate openings for the endoilluminator and the suction cutter. However, it was Steve Charles, MD, who took an innovative systems approach to the O'Malley instrumentation by providing vitreoretinal surgeons with such techniques as vacuum cleaning of preretinal hemorrhage, fluid-air exchange, internal drainage of subretinal fluid, endophotocoagulation,