V.B.2. Modern Vitrectomy Cutters: An Improved Understanding of Vitreous Cutting

Abstract

Thirty-seven years have passed since Robert Machemer developed a device and the technique for mechanized removal of vitreous from a closed eye. Over the past 37 years, vitrectomy has improved and is safer and more efficient [1]. We routinely operate not only on eyes with severe disease like complicated retinal detachment, penetrating ocular injury and diabetic retinopathy but also on eyes with less severe disease such as idiopathic preretinal membrane and even vitreous floaters. Instead of waiting until the vision declines to a low level, we are now operating on eyes before significant vision loss. This reflects the significant improvement in efficiency and safety of pars plana vitrectomy. Yet our understanding of the fundamental mechanisms of automated vitreous removal is incomplete. We must overcome this incomplete understanding if we are to achieve important breakthroughs in the design of vitreous cutters. In this chapter, work is presented which was performed in the Eye Concepts Laboratory at the Doheny Eye Institute on the mechanics of automated vitrectomy.