Carl C. Awh
SAN FRANCISCO — Hypersonic vitrectomy devices, a method of vitreous removal in which ultrasonic power is used to actuate a vitrectomy probe, has the potential to replace current state-of-the-art guillotine vitrectomy cutters, but advances need to be made to improve the device’s ability to cut thick membranes more effectively, a speaker said here.
“Is it time to replace the guillotine cutter? In my opinion, not yet. Although this device is excellent in most situations and has some expanded capabilities, there are some limitations. Occasionally I find it doesn’t work as well as my guillotine cutter, it doesn’t seem to have enough cutting power, that’s demonstrated in its tendency to sometimes create vitreous strands,” Carl C. Awh, MD, said at Retina Subspecialty Day at the American Academy of Ophthalmology annual meeting.
To date, over 200 surgical cases have ben performed by 17 surgeons using 23-gauge hypersonic vitrectomy devices. The first-generation device is capable of 1.8 million “cuts” per minute, with the next generation of the device capable of 2.5 million cuts per minute, Awh said.
The increased frequency of the second-generation device will increase the device’s cutting power and flow but will also increase the device’s turbulence. Researchers are currently developing adaptive frequency control to instantaneously adjust frequency in response to changes in tissue behavior, which will allow surgeons to optimize power and limit turbulence, as will optimized port geometry and smaller gauge probes, Awh said.
“Perfection alone is not reason enough to not seek further improvement. I think hypersonic vitrectomy has the potential to provide performance superior to current state-of-the-art guillotine vitreous cutters,” he said. – by Robert Linnehan
Awh CC. Hypersonic vitrectomy: Continued technical and clinical developments. Presented at: American Academy of Ophthalmology annual meeting; October 11-15, 2019; San Francisco.
Disclosures: Awh reports he is a consultant for Bausch + Lomb.