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Koen van Overdam, Sonia Manning; Intraocular Diathermy Forceps. Invest. Ophthalmol. Vis. Sci. 2017;58(8):5011.
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© ARVO (1962-2015); The Authors (2016-present)
Intraocular diathermy has not changed since it was pioneered in the 1970s. Current advanced vitreoretinal procedures call for the development of an improved multifunctional intraocular diathermy forceps. The purpose of this study was to develop intraocular diathermy forceps and test them in perfused porcine cadaver eyes.
We designed two types of 23-gauge intraocular bipolar diathermy forceps by modifying commercially available membrane peeling forceps. In the first type the emitting electrode is attached to the core and both jaws of the forceps and the return electrode to the surrounding tube. In the second type the emitting electrode is connected to one half of the core and the return electrode to the other half, with one jaw of the forceps attached to each half of the core. We compared the new diathermy forceps to conventional intraocular diathermy, on perfused porcine cadaver eyes. First order retinal artery and vein closure was confirmed both by a perfusion study and by histology of the treated vessels.
Type 2 diathermy forceps closed retinal arteries and veins more successfully (5/5 and 5/5 successful treatments, respectively) than Type 1 diathermy forceps (4/4 and 3/4 respectively) and conventional diathermy (3/5 and 4/5 respectively). Less energy was needed with the Type 2 diathermy forceps compared to Type 1 diathermy forceps and conventional diathermy for artery closure (1.5±0.0 vs 8.0±3.3 vs 2.1±0.8 joules, respectively) and for vein closure (1.5±0.0 vs 10.0±5.2 vs 2.4±0.8 joules, respectively). Histology showed that collateral damage to neighbouring retina was limited and not greater than that caused by conventional diathermy.
We have designed two types of a multifunctional instrument with the ability to grasp, compress and coagulate retinal vessels. Both types appear to have several advantages compared to the current conventional intraocular diathermy.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
Intraocular diathermy forceps and perfused porcine cadaver eye.
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