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Luiz Henrique Lima; Preliminary Clinical Outcomes of 23-Gauge Dual Port Vitrectomy Surgery.. Invest. Ophthalmol. Vis. Sci. 2016;57(12):5829.
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© ARVO (1962-2015); The Authors (2016-present)
The clinical advantages and disadvantages of the dual port cutter system are yet unknown. The purpose of this study was to evaluate the preliminary safety, efficiency and feasibility of a 23-gauge DP cutter system in a variety of vitreoretinal diseases.
Custom 180 degree DP cutters were fabricated from a standard single port cutter. The second port with a 0.019-inch diameter was placed at the distal end of the cutter tip (same height of the original port) and 180 degrees opposite the original port. All tips were mounted on a 23-gauge Accurus handpiece. In this prospective interventional study, a variety of vitreoretinal procedures were performed with a transconjunctival 23-gauge DP cutter by a single surgeon. The bulky vitrectomy was performed at 2,500 cuts per minute and at a vacuum level of 300 mmHg. Surgical outcomes, including anatomic success, visual acuity, operating time, intraoperative and postoperative complications were evaluated.
Thirty-two eyes of 32 patients (15 female and 17 male; average age of 65.3 +/- 7.9 years) underwent DP vitrectomy for diabetic vitreous hemorrhage (12 eyes), vitreous opacity (10 eyes), idiopathic macular hole (5 eyes), macular traction syndrome (3 eyes), and epiretinal membranes (2 eyes).The average operating time was 20.3 +/- 10.1 minutes. The average postoperative follow-up time was 13.7 +/- 5.3 months and best corrected visual acuity improved significantly from 0.73 logMAR to 0.41 logMAR over this period of time (p<0.005). Anatomic success was achieved in all eyes studied (100%). Post-operative hypotony (IOP < 7mmHg) and cataracts were observed in 2 eyes (6.2%) and 1 eye (3.1%), respectively. No other postoperative complications such as choroidal effusion, retinal break or detachment, or endophthalmitis were observed throughout the follow-up period. None of the studied eyes had intraoperative complications or required conversion to the standard cutter port.
The preliminary safety and practicality of the 23-gauge DP cutter system were confirmed for several vitreoretinal diseases. A faster operating time with few postoperative complications in our series suggests the potential of the 23-gauge DP cutter for treating vitreous hemorrhage, macular diseases, and vitreous opacity.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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