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Novel probabilistic model of core vitreous traction using microsurgical vitrectomy tools

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Abstract

Purpose

Traction exerted on the vitreous base during vitrectomy poses a risk for retinal tears. We aimed to quantify core vitreous traction during vitrectomy using spring return and pneumatic cutters.

Methods

Juvenile porcine vitreous was vacuum held in a vitreous bath while traction was measured using precision force gauge during vitrectomy. The parameters included were aspiration rate, cut-rate, cutter size, and machine types.

Results

An empirical probabilistic model was developed. The traction was proportional to the aspiration rate but insignificantly dependent on the cut-rate. The traction probability was inversely proportional to the exponential function of the traction (p < 0.05). The traction was < 0.003 N for 99% of the time using either 23- or 25-gauge cutters.

Conclusion

The tractions measured were considered similar to the causative forces of an iatrogenic retinal tear during a pars plana vitrectomy. The results provide a safety reference matrix of instrumental parameters during vitrectomy.

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Acknowledgments

The authors would like to thank Laurie Justin from USC for the statistical analysis using the SAS software.

Funding

This work was sponsored, in part, by the advanced royalty distribution from Bausch & Lomb Inc., Rochester, NY, USA, and unrestricted departmental support from Research to Prevent Blindness to the University of Southern California Roski Eye Institute.

Author information

Authors and Affiliations

  1. Department of Ophthalmology, Keck School of Medicine of the University of Southern California (USC), Los Angeles, CA, 90033, USA

    Jawchyng L. Lue

  2. Department of Ophthalmology, Keck School of Medicine USC, Los Angeles, CA, 90033, USA

    Ramiro Ribeiro & Michael J. Koss

  3. Department of Ophthalmology and Visual Sciences, Federal University of São Paulo, São Paulo, Brazil

    Paulo Falabella

  4. Ophtalmology Hospital, Federal University of São Paulo, São Paulo, Brazil

    Rodrigo Brant

  5. USC Dr. Allen and Charlotte Ginsburg Institute for Biomedical Therapeutics, Los Angeles, CA, USA

    Mark S. Humayun

  6. USC Roski Eye Institute at the University of Southern California (USC), Los Angeles, CA, 90033, USA

    Mark S. Humayun

Authors
  1. Jawchyng L. Lue
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  2. Ramiro Ribeiro
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  3. Michael J. Koss
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  4. Paulo Falabella
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  5. Rodrigo Brant
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  6. Mark S. Humayun
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Contributions

Conceptualization: Jawchyng L. Lue, Mark S. Humayun, Ramiro Ribeiro, and Rodrigo Brant; methodology: Jawchyng L. Lue, Ramiro Ribeiro, and Paulo Falabella; formal analysis and investigation: Jawchyng L. Lue, Ramiro Ribeiro, and Rodrigo Brant; writing— original draft preparation: Jawchyng L. Lue; writing—review and editing: Jawchyng L. Lue, Rodrigo Brant, Mark S. Humayun, Ramiro Ribeiro, Paulo Falabella, and Michael J. Koss; funding acquisition: Mark S. Humayun, and Jawchyng L. Lue; resources: Mark S. Humayun, Jawchyng L. Lue, Paulo Falabella, and Michael J. Koss; and supervision: Jawchyng L. Lue.

Corresponding author

Correspondence to Jawchyng L. Lue.

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Conflict of interest

The authors declare that they have no conflict of interest. This manuscript was submitted to Graefe’s Archive for Clinical and Experimental Ophthalmology on TBD for review. The sponsor organization had no role in the design or conduct of this research. The authors do not have any proprietary interests in the materials described in the article.

Ethical approval

All applicable international, national, and/or institutional guidelines for the care and use of animals were followed. The study used food-grade porcine eyes and is compliant with the guideline of Institutional Animal Care and Use of Committee of the University of Southern California. This article does not contain any studies with human participants or animals performed by any of the authors.

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Lue, J.L., Ribeiro, R., Koss, M.J. et al. Novel probabilistic model of core vitreous traction using microsurgical vitrectomy tools. Graefes Arch Clin Exp Ophthalmol 259, 405–412 (2021). https://doi.org/10.1007/s00417-020-04836-z

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  • DOI: https://doi.org/10.1007/s00417-020-04836-z

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