System can be used for anterior, posterior segment surgeries

The OS3 is used in cataract and vitreoretinal surgery, and in the future for glaucoma surgery.

ByMichela Cimberle

Advances in the technology of the OS3 system have improved its versatility and extended its capabilities from phacoemulsification and vitreoretinal surgery to include glaucoma surgery, according to one surgeon.

Amos Bartolino, MD, said the OS3 (Oertli Instruments) is ahead of most of the technology available because it provides maximum flexibility in switching between modes, times and settings, and it covers nearly all indications for anterior and posterior segment surgeries.

“The machine conforms to the highest standards of modern microsurgery, allowing us to perform the various types of surgery in a minimally invasive fashion,” he said.

Flexible system

Some valuable features of the OS3 are the double pump system and the capability of varying between burst and pulse modes, Dr. Bartolino said.

Burst mode has a defined time and fixed level of ultrasound energy application, but the pedal can control the interval between bursts.

Pulse mode has a defined pulse duration and interval, with the pedal controlling the amount of energy delivered for each pulse.

The latest development of the OS3 has doubled the frequency of pulse duration from 20 Hz to 40 Hz.

“This higher repetition rate makes ultrasound delivery more fluent and controllable,” Dr. Bartolino said.

In both cataract and vitreoretinal surgery, Dr. Bartolino said he likes to switch back and forth between venturi pump and peristaltic pump.

“I use the venturi pump in the first stages of phaco because it offers good followability without increasing the vacuum. Once the fragments are engaged in the tip, I switch to the peristaltic pump, which has excellent aspiration power,” he said. “During vitrectomy, I like to use the venturi pump at the beginning of the procedure, setting a high cutting speed to rapidly eliminate a large quantity of vitreous. I also use it for lifting the hyaloid membrane, placing the vitrectomy probe over the optic disc. On the other hand, the peristaltic pump can be used for polishing the vitreous base or in posterior vitrectomy, before removing the internal limiting membrane.”

The dual linear control of the foot pedal allows separate control of vacuum and ultrasound delivery with the venturi pump and of flow rate and ultrasound delivery with the peristaltic pump, Dr. Bartolino said.

Glaucoma surgery

A new feature of the OS3 is the modified diathermic probe for intrastromal diathermic keratectomy (IDK), a novel filtration procedure for glaucoma surgery. This method is aimed at creating a drainage route for the aqueous humor through an opening in the deep stroma, Dr. Bartolino said. A scleral incision is performed with the tip of the instrument, and the diathermy probe is embedded in the deep stroma to create a drainage tunnel between the anterior chamber and the subcapsular conjunctival space.

“IDK is a penetrating procedure, but no scleral flap is needed. Compared with trabeculectomy, it is faster, easier and far less invasive, but seems to be just as effective in lowering IOP, according to preliminary results,” Dr. Bartolino said.

Two month follow-up in a small cohort of patients showed stable IOP.

For Your Information:

Amos Bartolino, MD, is head of the ophthalmology department of Sassuolo Hospital, Italy. He can be reached at Ospedale Nuovo di Sassuolo, Unità Operativa di Oculistica, Sassuolo (MO), Italy; +39-3393190538; e-mail: amos.bart@quipo.it. Ocular Surgery News was unable to confirm whether Dr. Bartolino has a direct financial interest in the products mentioned in this article or if he is a paid consultant for any companies mentioned.

Oertli Instruments, maker of the OS3 system, can be reached at CH-9442 Berneck, Switzerland; +41-71-747-4200; fax: +41-71-747-4290; e-mail: info@oertli-instruments.com; Web site: www.oertli-instruments.com.

Michela Cimberle is an OSN Correspondent based in Treviso, Italy.