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      Impact of different manufacturers and gauge sizes on the performance of backflush needle

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          Abstract

          The present study aimed to identify the factors regulating aspiration rate (AR) of backflush needles and to compare those factors across various backflush needles from different manufacturers. The 27-gauge (27G), 25-gauge, and 23-gauge backflush needles from four different manufacturers, Alcon, MedOne, VitreQ, and DORC, were used for this experiment. AR was measured at four different aspiration vacuum levels: 100, 200, 400, and 650 mmHg. AR was significantly increased as the aspiration vacuum level increased when both aspirating balanced salt solution (BSS) and ethylene glycol; however, 27G products from VitreQ and MedOne were unable to aspirate ethylene glycol at the low aspiration vacuum level of 100 mmHg. When aspirating BSS at the high aspiration vacuum level of 650 mmHg, a smaller gauge number generally resulted in a significantly higher AR. AR, inner diameter, and cross-sectional area in Alcon products were significantly larger in any gauge, and the shaft length of Alcon products was significantly shorter than those of other manufacturers’ products in any gauge. Cross-sectional area negatively correlated with the degree of shaft deflection ( r 2  = 0.21, p = 0.042). These results imply that AR differs significantly among backflush needles and among companies depending on the shaft cross-sectional area.

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          A 27-gauge instrument system for transconjunctival sutureless microincision vitrectomy surgery.

          To evaluate the efficiency, preliminary safety, and feasibility of a 27-gauge instrument system for transconjunctival microincision vitrectomy surgery (MIVS) in a variety of vitreoretinal diseases.
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            Comparative study of 27-gauge vs 25-gauge vitrectomy for epiretinal membrane

            Purpose The purpose of this study was to compare 27-gauge (27G) with 25-gauge (25G) microincision vitrectomy in patients with epiretinal membrane (ERM). Participants Seventy-four eyes of 66 patients undergoing 3-port pars plana vitrectomy using 27G or 25G instrumentation. Methods Seventy-four eyes of 66 patients with ERM, who underwent 27G or 25G microincision vitrectomy were prospectively evaluated. Results The mean operation time for vitrectomy was significantly longer in the 27G group than in the 25G group (9.9±3.5 vs 6.2±2.7 min, respectively, P<0.0001). No statistically significant difference was found between the two groups in terms of the mean operation time for ERM–inner limiting membrane peeling (27G vs 25G: 20.2±9.9 vs 16.1±9.3 min, P=0.14), although the time for vitreous cutting was longer in the 27G group (9.9±3.5 vs 6.2±2.7 min, respectively, P<0.0001). The flare value, intraocular pressure (IOP), and rate of hypotony 1 day after surgery did not differ between the 27G and 25G groups (flare value: 18.7 vs 17.2; IOP: 8.8 vs 9.7 mm Hg; rate of hypotony: 30 vs 35%, respectively). There was no significant difference in the surgically induced astigmatism between the two groups in the follow-up period. The mean time required for wound closure did not show a significant difference between the 27G and 25G groups (7.7 vs 8.6 weeks, respectively). Conclusion The 27G system is as safe and useful for ERM vitrectomy as the 25G system. Based on its potential, further improvement of 27G instruments could result in greater efficiency.
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              Vitrectomy Fluidics

              The goal of all vitreous surgery is to perform the desired intraoperative intervention with minimum collateral damage in the most efficient way possible. An understanding of the principles of fluidics is of importance to all vitreoretinal surgeons to achieve these aims. Advances in technology mean that surgeons are being given increasing choice in the settings they are able to select for surgery. Manufacturers are marketing systems with aspiration driven by peristaltic, Venturi and hybrid pumps. Increasingly fast cut rates are offered with optimised, and in some cases surgeon-controlled, duty cycles. Function-specific cutters are becoming available and narrow-gauge instrumentation is evolving to meet surgeon demands with higher achievable flow rates. In parallel with the developments in outflow technology, infusion systems are advancing with lowering flow resistance and intraocular pressure control to improve fluidic stability during surgery. This review discusses the important aspects of fluidic technology so that surgeons can select the optimum machine parameters to carry out safe and effective surgery.
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                Author and article information

                Contributors
                hisimai@med.kobe-u.ac.jp
                Journal
                Sci Rep
                Sci Rep
                Scientific Reports
                Nature Publishing Group UK (London )
                2045-2322
                8 December 2020
                8 December 2020
                2020
                : 10
                : 21452
                Affiliations
                GRID grid.31432.37, ISNI 0000 0001 1092 3077, Division of Ophthalmology, Department of Surgery-Related, , Kobe University Graduate School of Medicine, ; 7-5-2 Kusunoki-cho, Chuo-ku, Kobe 650-0017 Japan
                Article
                78668
                10.1038/s41598-020-78668-6
                7722875
                33293659
                63a444a0-12f0-437a-bd9c-e6ec817d7309
                © The Author(s) 2020

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

                History
                : 26 August 2020
                : 25 November 2020
                Funding
                Funded by: Alcon Japan
                Categories
                Article
                Custom metadata
                © The Author(s) 2020

                Uncategorized
                eye diseases,medical research
                Uncategorized
                eye diseases, medical research

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