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Small-gauge vitrectomy system may reduce operative times
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LOS ANGELES — Use of a 25-gauge vitrectomy system may reduce operative times for select cases that do not require the full capability of conventional vitrectomy, according to a clinical study here. Infusion and aspiration rates of the 25-gauge instruments are lower than those for a 20-gauge high-speed vitrectomy system, according to an in vitro component of the study.
Clinicians here at the Doheny Eye Institute performed a variety of vitreoretinal procedures in 20 eyes of 20 patients using the 25-gauge transconjunctival sutureless vitrectomy system, or TSV, from Bausch & Lomb.
“The TSV is a new vitrectomy system that shows great potential usefulness and several possible advantages over conventional vitrectomy in select cases,” the study authors reported in the October issue of Ophthalmology. “In this study, we found that operative times can be effectively reduced in select cases in which the full capability of conventional vitrectomy is not required.”
Procedures included idiopathic epiretinal membrane, macular hole, rhegmatogenous retinal detachment, branch retinal vein occlusion, diabetic vitreous hemorrhage. Twenty cases similar in diagnosis and severity, performed with a standard 20-gauge system, were matched. Infusion, aspiration rates and operative times of the 20-gauge and 25-gauge vitrectomy systems were the main outcome measures.
In the in vitro portion of the study, infusion rates of the 25-gauge TSV system were reduced by 6.9 times when compared with the 20-gauge system using balanced saline solution. Aspiration rates were reduced an average 6.6 times when compared with the 20-gauge system using balanced saline solution.
The mean total operative time was significantly greater for the 20-gauge high-speed cutter than for the 25-gauge vitrectomy system (P = .011).