Establishing vitrectomy parameters may help determine case complexity
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Defining intraoperative parameters for vitrectomy may help shed light on the complexity of a case, according to a study presented at the American Society of Retina Specialists meeting.
“The problem is we really don’t have baseline intraoperative measures to quantify surgery outside of our operative notes and our great surgical videos,” Prethy Rao, MD, MPH, FACS, of Retina and Vitreous of Texas, said. “So, the question is, can we establish intraoperative surgical parameters to be able to link to our clinical outcomes?”
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Rao and colleagues retrospectively reviewed all surgical cases that required a vitrectomy collected by the Eyetelligence database, a national database of Stellaris machines (Bausch + Lomb) in the U.S. The study included 100,623 vitrectomies performed between Jan. 1, 2018, and Jan. 1, 2024, with an analysis of parameters related to vitrectomy cut rates, vacuum pressures, infusion pressures, and laser duration and energy; 74.2% of cases were performed in less than 1 hour, and 25.8% took longer than 1 hour.
“The purpose was to define the baseline surgical parameters in the cloud database and correlate that with duration and complexity,” Rao said.
Cases that were performed in less than 1 hour vs. more than 1 hour tended to have higher infusion pressures, cut rates and vacuum pressures. Surgeries longer than 1 hour were more likely to be performed with an elevated infusion pressure and stay at this elevated pressure for almost twice as long.
In a subset analysis of 34,789 vitrectomies that used both an endolaser and coagulation, longer case duration was linked with longer vitrectomy time, longer coagulation time, longer laser duration and higher laser energy, while shorter case duration was linked with higher vacuum pressures and shorter vacuum times.
“Case duration may potentially reflect complexity,” Rao said. “The implications are that we really want to create more standardized features of surgical parameters ... and we want to correlate that with good diagnosis.”
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Rao P, et al. Real-world intraoperative surgical parameters in the Eyetelligence cloud: A national surgical database of US vitreoretinal surgeons. Presented at: American Society of Retina Specialists annual meeting; July 17-20, 2024; Stockholm.
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