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A Smart Vitrector Equipped by a Fiber-Based OCT Sensor Mitigates Intentional Attempts at Creating Iatrogenic Retinal
Alexandre Abid1,2, Renaud Duval3,4, Flavio Rezende3,4
1Institute of Biomedical Engineering, University of Montreal, Montreal, Quebec, Canada.
Translational Vision Science & Technology
|November 12, 2021
Summary
A novel smart vitrector significantly reduces iatrogenic retinal breaks during pars plana vitrectomy (PPV) by detecting and preventing retinal cuts in real-time. This technology offers improved surgical outcomes and patient safety.
Area of Science:
- Ophthalmology
- Surgical Technology
- Medical Devices
Background:
- Iatrogenic retinal breaks (RB) are a complication of pars plana vitrectomy (PPV).
- These breaks occur when the retina is accidentally cut by the vitrector.
- Preventing RB is crucial for surgical efficacy and patient outcomes.
Purpose of the Study:
- To develop and evaluate a smart vitrector capable of detecting and preventing iatrogenic RB during PPV.
- To assess the real-time response of the smart vitrector system.
- To validate the system's efficacy in preventing simulated iatrogenic RB.
Main Methods:
- A miniaturized fiber-based OCT sensor was integrated into commercial 25G vitrectors.
- The system's response time was measured and compared to human surgeon reaction times.
- Ex vivo and in vivo porcine eye models were used to validate the prevention of simulated iatrogenic RB.
Main Results:
- The smart vitrector system demonstrated a response time 11 times faster than human surgeons (28.9 ± 6.5 ms vs. literature values).
- The system prevented 78.95% of simulated RB ex vivo and 55.68% in vivo.
- It prevented or mitigated 70.37% of simulated RB in vivo, with a false positive rate of 24.07%.
Conclusions:
- The smart vitrector effectively prevents iatrogenic RB by providing real-time feedback to the PPV machine.
- This technology integrates seamlessly into existing PPV procedures without modification.
- Clinical adoption can significantly reduce iatrogenic RB, improving surgical efficacy and therapeutic outcomes.
