1. Sep 04, 2020

Is there room for a new hypersonic vitrector in the clinical setting?

In this retrospective, single surgeon, non-consecutive series of cases, researchers compared hypersonic and guillotine style cutters attached to the same vacuum-based vitrectomy system. They found that hypersonic vitrector had modest intra-operative efficiency superiority compared to pneumatic guillotine style cutter. The authors concluded that larger sample size studies are needed but the technology looks promising.

Clinical Commentary by William F. Deegan III, MD

The article, “Evaluation of the Intra-operative Efficiency of a Novel Hypersonic Vitrector in Typical Clinical Settings” presents a new and potentially useful wrinkle to pars plana vitrectomy. The ease of performing vitrectomy, the high degree of success with the surgery, and patient acceptance of and recovery from the procedure have been the product of greatly improved instrumentation over the past twenty years. A vitrector offering more efficient cutting and/or suction, such as Gonzalez’s Novel Hypersonic Vitrector (NHV) would certainly be in line with the overall improvement in vitrectomy since Machemer et al. first envisioned and fashioned them over forty years ago.

Of course, as every surgeon knows, reliability and performance are as much a function of the human operator than anything else, so it will be interesting to see how experienced surgeons assess the NHV in the spectrum of vitrectomy surgeries (one important detail that is lacking in the study is a description of the indications for the surgeries that were performed).

Finally, as one who employs 25-guage vitrectomy instrumentation exclusively, I am left to wonder whether I would sacrifice the size of the scleral wound (and theoretically increase the chance of needing to suture) for a slight improvement in efficiency.  Time will tell…..

William F. Deegan III, MD is an ophthalmologist at Westchester Medical Center/New York Medical College; and a member of the Ophthalmology360 Editorial Advisory Board.  

Reference
Gonzalez V, et al. Evaluation of the intra-operative efficiency of a novel hypersonic vitrector in typical clinical settings. Presented at: 2020 ASRS Virtual Conference.