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      Review of Small Gauge Vitrectomy: Progress and Innovations

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      Author(s): 1 , 2 , * , 1
      Publication date (Electronic):
      Journal: Journal of Ophthalmology
      Publisher: Hindawi

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          Abstract

          Purpose. To summarise the surgical advances and evolution of small gauge vitrectomy and discuss its principles and application in modern vitreoretinal surgery. The advent of microincisional vitrectomy systems (MIVS) has created a paradigm shift away from twenty-gauge vitrectomy systems, which have been the gold standard in the surgical management of vitreoretinal diseases for over thirty years. Advances in biomedical engineering and surgical techniques have overcome the technical hurdles of shifting to smaller gauge instrumentation and sutureless surgery, improving surgical capabilities and expanding the indications for MIVS.

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          A new 25-gauge instrument system for transconjunctival sutureless vitrectomy surgery.

          Gildo Y Fujii, Eugene De Juan, Mark S Humayun … (2002)
          To introduce and evaluate the infusion and aspiration rates and operative times of the 25-gauge transconjunctival sutureless vitrectomy system (TSV) DESIGN: In vitro experimental and comparative interventional study. Twenty eyes of 20 patients underwent a variety of vitreoretinal procedures using the 25-gauge TSV, including idiopathic epiretinal membrane (n = 10), macular hole (n = 4), rhegmatogenous retinal detachment (n = 3), branch retinal vein occlusion (n = 2), diabetic vitreous hemorrhage (n = 1), and 20 cases similar in diagnosis and severity were matched to provide comparison between duration of individual portions of the surgical procedures with the existing 20-gauge vitrectomy system. Description of the 25-gauge TSV is provided; infusion and aspiration rates of the 25-gauge and standard 20-gauge vitrectomy system were measured in vitro using balanced saline solution and porcine vitreous for several levels of aspirating power and bottle height, and operating times of individual portions of surgical procedures were measured for the 25-gauge and 20-gauge vitrectomy system. Infusion, aspiration rates, and operative times of the 20-gauge and 25-gauge vitrectomy system. Infusion and aspiration rates of the 25-gauge TSV system were reduced by an average of 6.9 and 6.6 times, respectively, compared with the 20-gauge system when balanced saline solution was used. The average flow rate of the Storz 25-gauge cutter (at 500 mmHg, 1500 cuts per minute [cpm]) was 40% greater than that of the 20-gauge pneumatic cutter (at 250 mmHg, 750 cpm) but about 2.3 times less than the 20-gauge high-speed cutter (at 250 mmHg, 1500 cpm). Mean total operative time was significantly greater for the 20-gauge high-speed cutter (26 minutes, 7 seconds) than for the 25-gauge vitrectomy system (17 minutes, 17 seconds) (P = 0.011). Although the infusion and aspiration rates of the 25-gauge instruments are lower than those for the 20-gauge high-speed vitrectomy system, the use of 25-gauge TVS may effectively reduce operative times of select cases that do not require the full capability of conventional vitrectomy.
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            A 27-gauge instrument system for transconjunctival sutureless microincision vitrectomy surgery.

            Yusuke Oshima, Taku Wakabayashi, Tatsuhiko Sato … (2010)
            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.
            Article 0 comments Cited 92 times – based on 0 reviews     Review now
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              Transconjunctival sutureless 23-gauge vitrectomy.

              Claus Eckardt (2015)
              Article 0 comments Cited 84 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): J Ophthalmol
                Journal ID (iso-abbrev): J Ophthalmol
                Journal ID (publisher-id): JOPH
                Title: Journal of Ophthalmology
                Publisher: Hindawi
                ISSN (Print): 2090-004X
                ISSN (Electronic): 2090-0058
                Publication date (Print): 2017
                Publication date (Electronic): 10 May 2017
                Volume: 2017
                Electronic Location Identifier: 6285869
                Affiliations
                1Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong Eye Hospital, Kowloon, Hong Kong
                2Sint Augustinus Hospital, Wilrijk, Belgium
                Author notes

                Academic Editor: Ala Moshiri

                Author information
                http://orcid.org/0000-0001-8419-9034
                Article
                DOI: 10.1155/2017/6285869
                PMC ID: 5447313
                PubMed ID: 28589037
                SO-VID: d594f3da-ae9c-4389-b596-6a5ec99224fa
                Copyright © Copyright © 2017 Shaheeda Mohamed et al.
                License:

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 17 February 2017
                Date accepted : 29 March 2017
                Categories
                Subject: Review Article

                ScienceOpen disciplines: Ophthalmology & Optometry
                Data availability:
                ScienceOpen disciplines: Ophthalmology & Optometry

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