Eric Nudleman, MD, PhD
UC San Diego, Shiley Eye Institute
RETINA Roundup Co-Editor
An annual ritual at the AAO subspeciality day includes a rapid tour of the newest instrument and gadgets for vitreoretinal surgery presented by David Chow, MD. This year’s meeting did not disappoint. Some of the highlights included:
Alcon’s Ultravit 10K Beveled High Speed Vitrectomy Probe. The instrument’s beveled design allows the surgeon to get closer to the retinal surface when segmenting fibrous tissue, for example. It is available in 23, 25, and 27-gauge platforms.
Alcon also introduced the Hypervit, which is a dual blade design, with a beveled tip, allowing 20,000 cpm. The dual design allows constant aspiration, which provides consistent flow rates and reduces traction.
A two dimensional cutter (TDC) by DORC was also presented, highlighting a dual cutting design and constant aspiration design. Bausch and Lomb also introduced a dual blade design, called the Bi-Blade, with 15,000 cpm, dual cutting and consistent flow.
Several new forceps were presented.
The Ultra Peel forceps by DORC are a 27-gauge design with larger platforms to aid in removal of thicker membranes.
The Sharkskin forceps by Alcon feature laser ablated micro-structures on the back side of the forceps tip, allowing easier initiation of ILM flaps. Katalyst introduced the Stiff Dex, 27-gauge forceps with a retracting stiffening sleeve, allowing the instrument to be 55x stiffer to prevent bending of the shaft. Vitreq also developed a new 27-gauge ILM forceps that allow 25% increase in stiffness.
Koen Van OverDam introduced unique forceps with diathermy capability. This combined instrument allows one to coagulate without changing instruments. They are available in 23-gauge.
DORC developed a new 27-gauge light pipe with 65% increase in output. The instrument includes a sleeve that allows trans-scleral illumination with depression. Vitreq has created a new 29-gauge spotlight directional chandelier which has a novel fixation system to help secure it to the drape. Vitreq also developed a retractable tissue manipulator which can be easily inserted through valved trocars. The Maeno-Awh Supermanipulator by Katalyst features a soft silicone ball at the tip, along gentle manipulation of the ILM during ILM flap procedures.
A series of disposable backflush instruments by DORC were presented, which feature an improved slimline design and larger reservoir. Medone introduced a new subretinal cannula which is shorter and stiffer, allowing easier insertion into valved trocars. Bausch and Lomb has also developed high flow VFI cannulas, which allows 4.4x higher flow of silicone oil, decreasing the time for oil injection and removal.
A new marking depressor by Lyubomyr Lytvynchuk was presented, featuring a retractable element that is exposed when it is squeezed, allowing one to mark with ink at the same time as depressing. Another novel depressor design by Gary Ganiban, called the “Ganihand” features a device that provides a hemisphere of scleral depression hands free.
Geuder has developed a ring which can be placed on the cornea and provides tracks for the precise placement of the needles for use in the Yamane technique of lens fixation.
Finally, Vitreq introduced a “cryopen”, which is a disposable handhelp cryotherapy device which is preloaded with N20 gas and allows 12-15 uses per pen.
We look forward to testing these new instruments, as well as the innovations and refinements that we will see next year.