5 minute read
From smaller gauge instrumentation to better vitrectomy machines, vitreoretinal experts discuss emerging advancements in surgical retina
New Advances in Vitreoretinal Surgery
by Hazlin Hassan
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 37 th 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 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 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),
Prof. Kazuaki Kadonosono
Yokohama City University
School of Medicine
Vitreoretinal surgery has seen
When bigger Is not better
Yokohama, Japan 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.
Taking OCTA to the Next Level
The Canon Medical Xephilio OCT-A1 is powered by AI
Optical coherence tomography angiography (OCTA) has stepped into a new tomorrow with the entrance of Canon Medical Xephilio OCT-A1. The artificial intelligencepowered innovation is all about optimizing image quality, speed of acquisition with outstanding imaging capabilities, versatile reporting possibilities and even makes physical distancing safety a reality.
The Canon Medical Xephilio OCT-A1 offers cutting edge imaging results with the Intelligent Denoise capability, Canon’s deep learning technology that offers a new quality of OCTA images. This is achieved within a single individual scan without the need to acquire and merge multiple images by delivering images with greatly reduced image noise, increased detail and improved visibility within just seconds. Combined with the Flow Fusion technology, you can also sub-divide complex examinations for difficult-toimage patients and overcome signal dropouts caused by vitreous artefacts.
A Canon Medical Xephilio OCT-A1 scan can be done in 2 seconds. This not only helps you save time and enhance work efficiency, but ultimately, the shorter examination time increases your patient’s comfort and well-being. Scan results can be ready in a matter of seconds.
It’s not only its speed but also its outstanding image performance that impresses. The Canon Medical Xephilio OCT-A1’s outstanding digital resolution
of up to 1.6 µm enables detection and
distinction of 10 layers of the retina, including Bruch’s membrane. Thanks to Canon’s recognized optical expertise, its excellent native optical resolution combined with the averaging multiple scans (up to 200) help achieve amazing detail resolution.
Accurate scanning is also easy with the system’s integrated Scanning Laser Ophthalmoscope (SLO). The real-time retinal tracking not only provides precise monitoring of the examination; it also allows you to maintain the exact same scanning position automatically. As a result, the tracking reduces movement artefacts, providing consistent, high image quality. The software’s automatic selection of identical scan parameters for follow-up examinations makes for consistency and reliability in results.
For reporting, the Canon Medical Xephilio OCT-A1 provides a full range of tools including an extensive normative database. Thanks to its extensive
DICOM and EMR capability, results from multiple Canon imaging modalities can be stored, shared and analyzed as needed in your daily practice.
The Retinal Expert (RX) software fully integrated with the Xephilio OCT-A1 does not only work well as a database, it also serves as a viewing station that allows access to all patient data for reviewing and reporting from remote locations while the database remains on the systems.
The RX software is a very intuitive and
user friendly software with extensive
pre-settings for the scan protocols allowing efficient workflow and OCT user management.
Most of all, the intelligent Canon Medical Xephilio OCT-A1 is easy to use with its three-click function to complete an examination. Just point, align and shoot. There is no need for any joysticks. It offers a complete range of intelligent functions to enable fully automated examinations, making it easy for delegation of scanning operations to nurses or assistants.
In light of the new reality after COVID-19, keeping a safe physical distance is also now feasible with Canon Medical Xephilio OCT-A1 offering you
multiple possibilities to operate the
device in a safer, socially-distanced way. The OCT scanner can be operated easily from any PC, or tablet device over a network using a remote desktop solution (e.g. TeamViewer). The Canon Medical Xephilio OCT-A1 can be operated over the hospital network or via the Internet from another room in the hospital or even a different location.
