Iatrogenic Breaks in Microinvasive Ultrasonic Vitrectomy Surgery of Rhegmatogenous Retinal Detachment
Abstract
One of the challenges in vitrectomy surgery of rhegmatogenous retinal detachment is the occurrence of iatrogenic retinal breaks, with reported frequencies ranging from 2% to 14%. This complication is attributed to traction resulting from non-linear aspiration flow in guillotine principle-based vitrectomy. Ultrasonic vitrectomy, based on the energetic fragmentation of the vitreous body, provides a 100% duty cycle of the instrument, thereby creating a more uniform aspiration flow.
The purpose. To study the frequency and causes of iatrogenic ruptures in surgery of regmatogenic retinal detachment by microinvasive ultrasonic and pneumatic vitrectomy 25G in a comparative aspect.
Material and methods. Patients were divided into the main group (n = 61, USVE operations) and the control group (n=73, PGVE operations). Endovitreal interventions were performed according to the standard technique using the «Optimed Profi» microsurgical system. Vitrectomy procedures were performed according to standard techniques using the «Optimed Profi» system.
Results. The frequency of iatrogenic retinal breaks in the main group was 3.28%, compared to 8.22% in the control group (p=0.23).
Conclusion. The obtained data indicate a trend toward a reduced risk of iatrogenic retinal breaks when using ultrasonic technology; however, further studies with an expanded sample size are required to confirm this advantage.
About the Authors
B. M. Aznabaev
ФГБОУ ВО «Башкирский государственный медицинский университет» Минздрава России; ЗАО «Оптимедсервис»
Russian Federation
Russian Federation
T. I. Dibaev
ФГБОУ ВО «Башкирский государственный медицинский университет» Минздрава России; ЗАО «Оптимедсервис»
Russian Federation
Russian Federation
T. R. Mukhamadeev
ФГБОУ ВО «Башкирский государственный медицинский университет» Минздрава России; ЗАО «Оптимедсервис»
Russian Federation
Russian Federation
References
1. Aznabaev B. M. [et al.] Ul'trazvukovaya vitrektomiya: issledovanie skorosti udaleniya steklovidnogo tela v eksperimente i klinike (Ultrasonic vitrectomy: Study of the rate of vitreous body removal in experiment and clinic). Prakticheskaya meditsina. 2018;16 (4):56–60. (in Russ)
2. Dogramaci M., Lee E. J. K., & Williamson T. H. The incidence and the risk factors for iatrogenic retinal breaks during pars plana vitrectomy. Eye (London, England). 2012;26(5):718–722. (in Engl)
3. Stanga P. E. [et al.] First-in-Human Clinical Study To Investigate the Effectiveness and Safety of Pars Plana Vitrectomy Surgery Using a New Hypersonic Technology. Retina (Philadelphia, Pa.). 2020;40(1):16–23. (in Engl)
4. Carter J. B. [et al.] Iatrogenic retinal breaks complicating pars plana vitrectomy. Ophthalmology. 1990;97(7):848–853; discussion 854. (in Engl)
5. Mura M. [et al.] Iatrogenic retinal breaks in ultrahigh-speed 25-gauge vitrectomy: a prospective study of elective cases. The British journal of ophthalmology, 2016;100(10):1383–1387. (in Engl)
6. Blinder K. J. [et al.] Introduction to hypersonic vitrectomy. Current Opinion in Ophthalmology. 2019;30(3):133–137. (in Engl)
7. Stanga P. E. [et al.] Performance analysis of a new hypersonic vitrector system. PLoS ONE. 2017;12(6):1–15. (in Engl)
8. Rizzo S. [et al.] Comparative study between a standard 25-gauge vitrectomy system and a new ultrahigh-speed 25-gauge system with duty cycle control in the treatment of various vitreoretinal diseases. Retina (Philadelphia, Pa.). 2011; 31(10): 2007–2013. (in Engl)
9. Deuchler S. [et al.] Safety and Efficacy of Hypersonic Vitrectomy for Retinal Reattachment Surgery in Proliferative Vitreoretinopathies. Clinical Ophthalmology. 2022;16:3711–3720. (in Engl)
10. Tan H. S. [et al.] Iatrogenic retinal breaks in 25-gauge macular surgery. American journal of ophthalmology. 2009;148 (3): 427–430. (in Engl)
11. Aznabaev B. M. [et al.] Twenty-Five Gauge Ultrasonic Vitrectomy. Retina (Philadelphia, Pa.). 2020;40 (7):1443–1450. (in Engl)
12. Teixeira A. [et al.] Vitreoretinal traction created by conventional cutters during vitrectomy. Ophthalmology. 2010; 117(7):1387– 1392.e2. (in Engl)
13. Sposob ul'trazvukovoi fragmentatsii steklovidnogo tela glaza (Method of ultrasonic fragmentation of the vitreous body of the eye): patent RU 2 752 514 C1 Ros. Federatsii; zayavl. 28.07.2020; opubl. 28.07.2021. Byul. № 22:10. (in Russ)
14. Ul'trazvukovaya igla dlya oftal'mokhirurgii (Ultrasonic needle for ophthalmic surgery): patent RU 2 685 902 C1 Ros. Federatsii; zayavl. 14.12.2017; opubl. 23.04.2019. Byul. № 12:9. (in Russ)
Review
For citations:
Aznabaev B.M., Dibaev T.I., Mukhamadeev T.R. Iatrogenic Breaks in Microinvasive Ultrasonic Vitrectomy Surgery of Rhegmatogenous Retinal Detachment. Bashkortostan Medical Journal. 2025;20(2):94-97. (In Russ.)
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