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    New vitrectomy technologies advance precision, efficiency during surgery

    Faster cut rate and smaller gauge add benefits without compromises


    Los Angeles—A new ultra-high-speed vitrectomy cutting probe operating at 7,500 cuts per minute (Ultravit High Speed Vitrectomy Probe, Alcon Laboratories) combined with use of 27+ gauge instrumentation enables safer and more efficient vitrectomy surgery, according to Pravin Dugel, MD.

    “Cutting at a faster rate creates less traction on the collagen fibrils that in turn reduces the chance of iatrogenic tears and retina incarceration, while use of smaller-gauge instrumentation allows a smaller incision size but more importantly improves precision for greater safety and efficiency,” said Dr. Dugel, managing partner, Retinal Consultants of Arizona, Phoenix, and clinical professor, Department of Ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles.

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    “The 27+ gauge instrumentation with the ultra-high-speed cutter is an appealing combination, because it allows me to remove fibrous tissue safely and effectively in a complicated traction detachment without the need for multiple instrument exchanges,” Dr. Dugel said.

    Fluidics of vitrectomy

    The benefit of smaller-gauge instrumentation is understood on a concept Dr. Dugel named “the sphere of influence” that relates to area of fluidic collateral damage. As instrument gauge size becomes smaller, so does the sphere of influence, and this decreases the amount of flow needed to attract tissue. Less flow translates into less collateral fluidic damage and therefore greater surgical precision.

    Dr. Dugel explained this concept using different size vacuum cleaners to retrieve a certain color candy-coated chocolate from a group of candies. The ability to pick up the single-color candy by itself was improved using a hose with a smaller diameter. (See videos this page)

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