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New-generation cannula overcomes fluidic challenges of small-gauge vitrectomy surgery
NICE, France — A new-generation cannula with a closed tip and four vent ports along the tube improves safety and efficiency regarding injection of perfluorocarbon liquids, staining dyes or other fluids during small-gauge vitrectomy surgery, according to one speaker.
With the advent of microincision vitrectomy surgery, the 20-gauge cannula has been scaled down to 23 gauge, 25 gauge and 27 gauge. Reduction of the lumen has resulted in two notable fluidic challenges, Okan Toygar, MD, said at the Euretina meeting.
Okan Toygar
“On one hand, impingement pressure and the risk of axial fluid jet damage to the retina increase with the decreasing diameter of the cannula. On the other hand, reduced passive outflow results in increased IOP,” he said.
The SideFlo cannula (MedOne Surgical) creates a broad fan-like egress of fluid perpendicular to the axial direction of the cannula and eliminates the possibility for retinal fluid jet damage, allowing significant improvement in pressure relief during injection.
The performance of the cannula was evaluated in 76 eyes of 70 patients, Toygar said. The rigidity of the cannula was satisfactory in all eyes for all gauges, no cannulas were bent or broken, and all injections were smooth and subjectively non-inferior to first-generation cannula designs. No turbulence or axial fluid jet was observed during perfluorocarbon liquid injection in any patient. Indocyanine green dye was noted to egress the terminal injection port as a broad perpendicular fan of dye without an axial fluid jet in all eyes.
“This new-generation cannula should strongly be considered to replace first-generation axially injecting cannulas for all intravitreal administration of liquids or liquid suspensions,” Toygar said. – by Michela Cimberle
Disclosure: Toygar reports no relevant financial disclosures.