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RANDOMIZED TRIAL COMPARING MICROSERRATED VERSUS CONVENTIONAL INTERNAL LIMITING MEMBRANE FORCEPS FOR INTERNAL LIMITING
Matthew R Starr1, John C Hinkle2, Luv G Patel2
1Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota; and.
Purpose:
To evaluate anatomic outcomes and surgeon response following the use of microserrated (Sharkskin, Alcon, Forth Worth, TX) internal limiting membrane (ILM) forceps compared with conventional (Grieshaber; Alcon) ILM forceps for peeling of the ILM.
Methods:
Patients were prospectively assigned in a 1:1 randomized fashion to undergo ILM peeling using microserrated forceps or conventional forceps. Rates of retinal hemorrhages, deep retinal grasps, ILM regrasping, time to ILM removal, and surgeon questionnaire comparing the use of microserrated and conventional ILM forceps were analyzed.
Results:
A total of 90 eyes of 90 patients were included in this study. The mean number of deep retinal grasps was higher in the conventional forceps group (1.51 ± 1.70 vs. 0.33 ± 0.56, respectively [P < 0.0001]). The mean number of failed ILM grasps was higher with conventional forceps (6.62 ± 3.51 vs. 5.18 ± 2.06 [P = 0.019]). Microserrated forceps provided more comfortability (lower number) in initiating the ILM flap (2.16 ± 0.85 vs. 1.56 ± 0.76, P < 0.001), comfortability in regrasping the ILM flap (2.51 ± 1.01 vs. 1.98 ± 0.89, P = 0.01), and comfortability in completing the ILM flap (2.42 ± 1.03 vs. 1.84 ± 1.02, P = 0.01).
Conclusion:
Surgeons utilizing the microserrated forceps experienced fewer deep retina grasps and fewer failed ILM grasps compared with conventional ILM forceps. The microserrated forceps was also a more favorable experience subjectively among the surgeons.
Insights
Microserrated internal limiting membrane (ILM) forceps reduce deep retinal grasps and failed grasps during ILM peeling surgery. Surgeons found microserrated forceps more comfortable and effective than conventional forceps.
Area of Science:
- Ophthalmology
- Retinal Surgery
- Surgical Instrumentation
Background:
- Internal limiting membrane (ILM) peeling is a critical step in various retinal surgeries.
- Conventional ILM forceps can lead to complications such as deep retinal grasps and multiple attempts at ILM removal.
- Improving surgical instrument design is essential for enhancing patient outcomes and surgeon experience.
Purpose of the Study:
- To compare the anatomic outcomes and surgeon response of microserrated (Sharkskin) ILM forceps versus conventional ILM forceps.
- To evaluate the efficacy and safety of microserrated forceps in ILM peeling procedures.
Main Methods:
- A prospective, 1:1 randomized study involving 90 eyes.
- Patients were assigned to undergo ILM peeling with either microserrated or conventional ILM forceps.
- Data collected included rates of retinal hemorrhages, deep retinal grasps, ILM regrasping, time to ILM removal, and surgeon feedback via questionnaires.
Main Results:
- Microserrated forceps resulted in significantly fewer deep retinal grasps (0.33 vs. 1.51, P < 0.0001) and failed ILM grasps (5.18 vs. 6.62, P = 0.019) compared to conventional forceps.
- Surgeons reported higher comfortability with microserrated forceps for initiating, regrasping, and completing ILM flap removal (P < 0.001 for initiation, P = 0.01 for regrasping, P = 0.01 for completion).
Conclusions:
- Microserrated ILM forceps offer improved surgical performance by reducing retinal trauma and improving ILM removal efficiency.
- Surgeons subjectively preferred microserrated forceps due to enhanced comfort and control during ILM peeling.
- These findings suggest microserrated forceps are a valuable advancement in retinal surgical instrumentation.
