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H. Quiroz-Mercado, C. C. Patel, S. C. Oliver, J. Olson, N. Mandava; 25 Gauge Plus Vitrector in Lieu of Vitreoretinal Forceps for Epiretinal Membrane and Internal Limiting Membrane Peeling. Invest. Ophthalmol. Vis. Sci. 2010;51(13):1763.
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© ARVO (1962-2015); The Authors (2016-present)
Epiretinal membrane (ERM) peeling and internal limiting membrane (ILM) peeling from the retina at the macular area are maneuvers frequently achieved by means of a vitreoretinal forceps. The Alcon 25 gauge plus vitrector was evaluated as new tool for removal of ERM and ILM. We evaluated relatively simple and harmless maneuvers used in macular surgery.
A total of fifteen isolated maneuvers were tested using the 25 gauge plus vitrector in combination with the Tano diamond dusted scraper. These maneuvers were performed without risking or modifying the surgical plan. All maneuvers involved either macular ERM or ILM peeling. ILM peeling was done with assistance of indocyanine green (ICG) stain in all cases to help confirm ILM removal. A maneuver was qualified as successful if it was achieved as if the regular procedure were performed using vitreoretinal forceps. It was deemed unsuccessful if another instrument was required to complete the maneuver safely.
Fourteen (93.3%) maneuvers were qualified as successful and one (6.7%) involving ILM peeling was qualified as unsuccessful. The vitrector alone allowed separation and dissection of ERM and ILM from the retina in the majority of cases without need for vitreoretinal forceps. New features of the 25 gauge plus system including increased vitrector probe stiffness and a cutter opening closer to the tip of the vitrector allow membranes to be engaged, separated and removed from the retina precisely and safely. Additionally, once engaged by the vitreous cutter, membranes can be peeled with the cutter tip a safe distance from the retina.
The new Alcon 25 gauge plus vitrector can be used successfully in lieu of a vitreoretinal forceps for macular ERM and ILM peeling.
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