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28 June 2020 | Issue #2
New Advances in Vitreoretinal Surgery by Hazlin Hassan
“Advances in surgical systems including microincision vitrectomy surgery (MIVS), non-contact operating microscope and 3D headup, now allow surgeons to perform better vitrectomies for proliferative diabetic retinopathy (PDR).” Prof. Kazuaki Kadonosono Yokohama City University School of Medicine Yokohama, Japan
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itreoretinal surgery has seen dramatic changes over the last 10 years with the emergence of new techniques, smaller gauge instrumentation, and better vitrectomy machines. During a surgical retina session on day two of the 37th World Ophthalmology Congress (WOC2020 Virtual®), an allstar cast featuring renowned surgeons from around the world discussed the latest cutting edge technologies in the surgical field of retina that allow even better surgical outcomes and fewer complications than ever before.
“Visualization is mandatory. We need to be able to see exactly what we are doing and be able to perform a dissection of this tissue from the retina surface to avoid the creation of retinal breaks which is a mandatory condition to avoid 100% failure and no light perception.” Prof. Marco Mura King Khaled Eye Specialist Hospital (KKESH) Riyadh, Saudi Arabia
When bigger Is not better For Prof. Marco Mura from King Khaled Eye Specialist Hospital, Saudi Arabia, he finds that the latest in smaller gauge vitrectomy probes are better, when it comes to treating retinopathy of prematurity (ROP). Here, the stakes are high. In stage 5 ROP, if a break develops, that’s 100% failure. “Visualization is mandatory. We need to be able to see exactly what we are doing and be able to perform a dissection of this tissue from the retina surface to avoid the creation of retinal breaks which is a mandatory condition to avoid 100% failure and no light perception,” Prof Mura cautioned. Improvements in technology including smaller gauge vitrectomy probes, new illumination techniques, and 3D digital visualization systems will help in the treatment of this complex disease with potentially better anatomical and functional results.
See it in 3D Advances in surgical systems including microincision vitrectomy surgery (MIVS), non-contact operating microscope and 3D head- up, now allow surgeons to perform better vitrectomies for proliferative diabetic retinopathy (PDR),
said Prof. Kazuaki Kadonosono from Yokohama City University School of Medicine, Japan. “3D vitrectomy offers advantages such as better depth of field, higher resolution, lower risk of phototoxicity, and opportunities for digital enhancement,” he explained. Surgical techniques such as bimanual procedures have also improved, resulting in decreasing surgical complications.
Surgeons and their need for speed “Why do we want to go faster?” asked Dr. David Chow from University of Toronto, Canada. “As we make quicker cuts, we take smaller bites of tissue, and we are inducing less traction.” One fast tool is Alcon’s ULTRAVIT® 10K bevel high speed vitrectomy probe which has a bevel tip design that allows the port to get closer to the retina, with less turbulence at 10,000 cpm and reduced backflow. Another device that Dr. Chow discussed is the Bi-Blade® dual port vitrectomy cutter from Bausch and Lomb. Its innovative dual blade design offers consistent flow rates, and reduced retinal traction at 15,000 cpm. Alcon is also releasing their version of a dual-blade cutter, the 20,000 cpm HYPERVIT® dual blade vitrectomy probe.
