ZusammenfassungUm 1970 herum wurde erstmals ein Schneidegerät, in welches ein Infusions- und ein Aspirationskanal integriert wurden – der „vitreous infusion suction cutter“ (V.I.S.C) –, standardmäßig für die Entfernung des Glaskörpers angewandt. Schneidesysteme haben sich von da an immer weiter entwickelt. Schallenergie blieb lange den Vorderabschnittschirurgien vorbehalten. Ab 2020 kann in Form der Vitesse™ Schall auch für den Hinterabschnitt genutzt werden. Bei diesem Verfahren der Liquifizierungstechnik wird Ultraschallenergie auf ein einzelnes, großes inneres Lumen übertragen, das den Port der Nadel mechanisch in Schwingung versetzt. Diese Hochgeschwindigkeitsvibrationen scheren den Glaskörper an den Portkanten ab, bevor er in die Nadel eintritt. Dieser Mechanismus minimiert die Traktion des Glaskörpers und ermöglicht eine schnellere Aspiration bei niedrigerem Vakuum im Vergleich zu herkömmlichen Schneidesystemen. Diese Vorteile können zu einer sichereren und effizienteren vitreoretinalen Chirurgie führen.
Ein Erratum zu dieser Publikation wurde veröffentlicht: 10.1007/s00347-021-01377-6
Introduction To investigate the safety and efficacy of the Vitesse hypersonic vitrectomy device for retinal reattachment surgery in proliferative vitreoretinopathy (PVR) or proliferative diabetic vitreoretinopathy (PDVR) cases. The Vitesse device utilizes hypersonic technology to liquefy instead of cutting the vitreous, providing an alternative to the traditional pneumatic guillotine cutter. Material and Methods A prospective, one-armed, non-comparative, open-label study was performed. Sixteen patients with a diagnosis of PVR or PDVR that required retinal reattachment surgery were included. Severity of disease was classified using the Retina Society 1983 classification and Kroll Classification from 2007. Patient data was collected preoperatively, 2 days postoperatively, 1 month postoperatively, and 3 months postoperatively. Efficacy of hypersonic vitrectomy was evaluated, both subjectively using a questionnaire and objectively by means of Supplementary Video documentation, device settings, and data collection of the patients’ medical history. Results In all 16 cases, retinal reattachment surgery could be performed with Vitesse without conversion to a guillotine cutter. The vitreous could be separated from the detached retina completely with no iatrogenic tissue damage. Vitreous traction was documented in one case. In 6 cases, shaving of the vitreous base was performed after early fluid–air exchange with hypersonic vitrectomy without any complications. No adverse events suspected to be related to hypersonic vitrectomy were documented in the follow-up visits. Conclusion The Vitesse has potential advantages including reduced vacuum volumes with limited amount of turbulence and avoidance vitreoretinal traction. Liquefaction directly in front of the probe entrance allows for continuous unrestricted fluid flow. These factors of hypersonic technology allow to carry out retinal reattachment surgery in PVR or PDVR cases successfully.
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