Evaluation of the Efficiency and Safety of a 27-Gauge 20,000 Cuts per Minute Vitreous Cutter

Abstract

Purpose

The aim of this study was to evaluate the efficiency and safety of a 27-gauge (G) 20,000 cuts per minute (cpm) vitreous cutter in clinical settings.

Patients and Methods

This was a retrospective and observational study of 40 eyes of 40 patients with idiopathic epiretinal membrane (ERM). Twenty patients (20 eyes) were treated using a 27G 10,000-cpm vitreous cutter (Advanced ULTRAVIT^® Probe, Alcon), whereas the remaining 20 patients (20 eyes) were treated using a 27G 20,000-cpm cutter (Hypervit^® dual-blade probe, Alcon). All the surgeries were performed by the same surgeon (YM). The time from the start of vitrectomy to the start of ERM peeling was independently measured by two separate examiners using digital videos of each surgery. The average duration of vitrectomy was calculated for each patient. Additionally, the data of the patients in the two groups were extracted from their medical and surgical records and compared.

Results

The time from the initiation of vitrectomy until the start of ERM peeling was 184 ± 56.9 and 152 ± 39.5 s for the 10,000-cpm and 20,000-cpm groups, respectively. The duration of vitrectomy was significantly shorter in the 20,000-cpm group than in the 10,000-cpm group (p = 0.041). Postoperative vitreous hemorrhage was observed in one patient in the 10,000-cpm group, whereas no complications were observed in the 20,000-cpm group.

Conclusion

In a clinical setting, the 27G 20,000-cpm vitreous cutter may have a higher safety profile and higher efficacy for vitreous removal than that of the 27G 10,000-cpm vitreous cutter.

Keywords:

• pars plana vitrectomy
• 20
• 000-cpm cutter
• 10
• 000-cpm cutter
• epiretinal membrane

Acknowledgments

The abstract of this paper was presented at the EURETINA 2022 Hamburg as a e-poster presentation with interim findings.

Author Contributions

All authors have significantly contributed to the work reported in various ways, whether in the conception, study design, execution, acquisition of data, analysis, interpretation, or across these areas. YD and YM had full access to all the study data and take responsibility for the integrity of the data and the accuracy of the data analysis.

Each author participated in drafting, revising, or critically reviewing the article. All authors have given their final approval of the version to be published. They have agreed collectively on the journal to which the article has been submitted. Furthermore, every author has reviewed and consented to all versions of the article - before submission, during revision, the final version accepted for publication, and any significant changes introduced at the proofing stage. Lastly, all authors agree to take responsibility and be accountable for the entirety of the work presented in the article.

Disclosure

Yuki Muraoka has received grant and financial support from Bayer Yakuhin, Novartis Pharma, Canon, Santen Pharmaceutical, Senju Pharmaceutical, and AMO Japan. Akitaka Tsujikawa has received grant and financial support from Canon, Findex, Santen Pharmaceutical, Kowa Pharmaceutical, Pfizer, AMO Japan, Senju Pharmaceutical, Wakamoto Pharmaceutical, Alcon Japan, Alcon Pharma, Otsuka Pharmaceutical, Tomey Corporation, Taiho Pharma, HOYA, Bayer Yakuhin, Novartis Pharma, Chugai Pharmaceutical, Astellas, Eisai, Daiich-Sankyo, Janssen Pharmaceutical, Kyoto Drug Discovery & Development, Allergan Japan, MSD, Ellex, Sanwa Kagaku Kenkyusho, Nitten Pharmaceutical, Kyowa kirin, and AbbVie GK. None of the abovementioned funding sources were involved in the design, conduct, and preparation of this study or the writing of the article. The authors report no other conflicts of interest in this work.

Additional information

Funding

This work was partially supported with an investigator-initiated study grant from Alcon Japan, Ltd. (Tokyo, Japan), a grant-in-aid for scientific research (Grant number 20K09771) from the Japan Society for the Promotion of Science (Tokyo, Japan), and by Canon INC. (Tokyo, Japan). The funders had no role in the study design, data collection, analysis, decision to publish, or manuscript preparation.