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Multicenter Study
. 2021 Dec 1;41(12):2523-2530.
doi: 10.1097/IAE.0000000000003215.

TWENTY-THREE-GAUGE HYPERSONIC VITRECTOMY: Real-World Surgical Evidence

Mario R Romano  1   2 , Luigi Caretti  3 , Mariantonia Ferrara  4 , Alvise La Gloria Valerio  3 , Matteo Fallico  5 , Rodolfo Repetto  6 , Teresio Avitabile  5
Affiliations
Multicenter Study

TWENTY-THREE-GAUGE HYPERSONIC VITRECTOMY: Real-World Surgical Evidence

Mario R Romano et al. Retina. .

Abstract

Purpose: To evaluate the safety, effectiveness, and the best parameters setup of hypersonic vitrectomy.

Methods: A prospective, multicentric, interventional study on 50 eyes that had undergone hypersonic vitrectomy because of various vitreoretinal diseases. We primarily assessed the effectiveness of vitreous removal, intraoperative complications, and surgical setup. Secondarily, we evaluated single-surgery anatomical success and postoperative best-corrected visual acuity.

Results: Intraoperative complications occurred in 5 eyes (10%), whereas technical problems were detected in 23 eyes (46%), resulting in conversion to guillotine vitrectomy in 15 cases. The most common finding related to the technical problems was an inadequate vitreous liquefaction with the formation of vitreous strands and consequent inadequate vitreous outflow, sometimes complicated by vitreous incarceration in the vitrectomy probe. The best settings were considered a stroke of 60 µm and vacuum of 40 mmHg for both core and peripheral vitrectomy. At 3-month follow-up, primary anatomical success was achieved in 49 eyes (98%) and the mean best-corrected visual acuity overall improved.

Conclusion: The availability of hypersonic vitrectomy in the current surgical practice opens a new era in vitreoretinal surgery. Despite the potential advantages in fluidics, the performance of hypersonic vitrectomy system needs to be further optimized, mainly for the occurrence of inadequate vitreous liquefaction and vitreous strands formation.

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References

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    1. Pastor-Idoate S, Bonshek R, Irion L, et al. Ultrastructural and histopathologic findings after pars plana vitrectomy with a new hypersonic vitrector system. Qualitative preliminary assessment. PLoS One 2017;12:e0173883.
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