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Micro Incisional Vitrectomy (MIVS): a new device for trocar insertion
Author(s) -
RIZZO S,
GENOVESIEBERT F
Publication year - 2008
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2008.5424.x-i1
Subject(s) - cannula , sclera , medicine , vitrectomy , surgery , fibrous joint , ophthalmology , visual acuity
Purpose Despite its clinical advantages, MIVS poses significant challenges in performing airtight incisions especially dealing with 23‐gauge system. Aim of this paper was to assess the feasibility of performing 23‐g MIVS using an injector system for trocar insertion. Methods 60 consecutive eyes of 56 patients underwent 23‐g pp vitrectomy and gas endotamponade for the treatment of Regmatogenous Retinal detachment and Diabetic Prolipherative Retinopathy by the same surgeon (SD). 30 eyes were operated on with standard one‐step 23‐g and 30 using a prototype of injector holding the same 23‐g trocar cannula system. The trocar squeezed into the plunger of the injector. The device had a metallic terminal oriented with a fix angle, allowing the insertion in the settled direction, able to fix the globe and displace the conjunctiva at the same time.Main outcome measure were sclerotomies airtightness, surgical time and complications. Results In the 30 eyes operated with the 23‐g ones step system 9 sclerotomies were sutured, in 5 refilling was required. Mean surgical time were 54 minutes. In the 30 eyes operated with the new device, the inserter was easy to apply in all cases and was useful especially in the nasal quadrant. Also dealing with sunken eyes the inclination of the system 5‐10° tangential to the sclera was easily achieved. No suture was placed, refilling was needed in 3 cases. Mean surgical time was 45 minutes. No complications due to these device were highlighted. Conclusion The new injector was safe and effective. The device facilitates the insertion manoeuvre allowing easier and quicker trocar positioning helping the airtight wound construction. MIVS success lie in the surgeon’s skill but also in the development of the technology and instrumentations.