Purchase this article with an account.
S. Rizzo, C. Azzolini, F. Genovesi–Ebert, S. Zenoni, C. Mariotti, M. Palla; Effectiveness of High Speed Vitrectomy . Invest. Ophthalmol. Vis. Sci. 2006;47(13):4216.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
to evaluate the effectiveness, safety and advantages of the High Speed Vitrectomy 2.500 cut/min vs standard Vitrectomy 800 cut/min in a observational prospectic multicentric study.
111 patients underwent total vitrectomy (core vitrectomy and 360° vitreous basis removal) due to different vitreoretinal diseases. Exclusion criteria were: age< 18 years, post traumatic vitreoretinal diseases, myopia >8 diopters, previous vitreoretinal surgeries, combined cataract surgery and vitrectomy. Group I of 54 patients was operated using a setting of 800 cuts per minute, 0–150 vacuum and PropVac modality. Group II of 57 patients was operated using a setting of 1500–2500 cuts per minute, 60–200 vacuum and dual mode (3D) modality. Data were collected in a dedicated on–line web data–base. Main outcome was the surgical time, secondary goals were the amount of BSS consumption and the number of instruments change (vitrectomy cutter–forceps and scissors) during the surgery. Intra–operative complications were recorded.
In Group I (standard vitrectomy) surgical time of vitrectomy was 639 seconds, number of instruments change (mean) 3.38, and BSS consumption 101,19 gr. In Group II (high speed vitrectomy) surgical time of vitrectomy was 527 sec, number of instruments change (mean) was 1,88, and BSS consumption 78,366 gr. There is a statistical significance in the surgical time between the two groups (P=0.0014) (Fig 4–5–6) . Intraoperative complications rate were 4/57 (7%) with Accurus 800 and 2/54 (3,7%) with Accurus 2500.
High Speed Vitrectomy System significantly reduces the surgical time of vitrectomy. Other advantages are the reduction of BSS consumption and instrument changes. High cutting rates produce greater fluidic resistance at the port than low cutting rates. The flow limiting effect reduces the fluid surge that with the Venturi pump occurs after the entrance of dense material through the port. The reduced BSS consumption with 2500 system is an indirect evidence of the increased fluidic stability in the vitreous chamber.
The complication rate was less with High Speed System. High cutting rates reduce the trans–orifice pressure variation that occurs with each port open/close cycle, decreasing surgically induced retinal motion: therefore reduces the high risk of complications when operating near mobile peripheral retina, vitreous basis, retinal degenerations and fibro–vascular stalks.Therefore our study shows that high speed vitrectomy is a useful technique that allows a more rapid, safe and feasible vitrectomy.
This PDF is available to Subscribers Only