Abstract
Purpose :
The development of small gauge vitrectomy has improved rates of self-sealing sclerotomies and decreased post-operative pain and inflammation. However, concerns regarding vitrector bending with smaller gauge sizes remains an area of concern. Therefore, the purpose of this study was to investigate the mechanical properties and stiffness of 23-, 25- and 27-gauge vitrectomy vitrectors across three different vitrectomy systems to inform surgical techniques.
Methods :
Nine vitrectors (3 each of 23-, 25-, and 27 gauge) from Alcon, DORC and Bausch and Lomb (B/L) were measured. The force required to vertically displace each vitrector by 1mm at the tip and 15mm from the tip was measured using an electronic force gauge (Electroforce 5500 Thermal Analysis Instruments, USA). Measurements were recorded in gramforce (gf). Five measurements were performed at each location and fully elastic deformation was ensured. One way ANOVA and Post-Hoc Tukey analysis were performed to evaluate statistical significance.
Results :
Across brands, B/L demonstrated the least stiffness at both the tip and at 15mm for 23-gauge (8.0±0.3 gf, 67.3±1.0 gf), 25-gauge (6.8±0.3 gf, 60.5±0.4 gf) and 27-gauge (3.3±0.1 gf, 33.9±0.5 gf) vitrectors. Within each brand, the 25 gauge vitrector was less stiff than the 23 gauge vitrector and the 27 gauge vitrector was less stiff than the 25 gauge vitrector at both tip and 15mm. These differences were statistically significant for Alcon (P<0.001, P<0.001), DORC(P<0.001, P<0.001) as well as B/L (P<0.001, P<0.001).
Conclusions :
Based on this study, 25-gauge vitrectors, although larger than 27-gauge vitrectors and less stiff than 23-gauge vitrectors, may offer favorable compromise between stiffness and gauge size. However, surgeon experience, preference, and expertise should be paramount. Knowledge of these mechanical properties may aid surgeons in choosing between gauge size and vitrectomy system to optimize their comfort and efficiency.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.