Vitreous Sensing Vitrectomy

Adequately visualizing the vitreous at times during vitrectomy can be challenging for surgeons. We describe a novel technique using surgical data from the vitrectomy machine to differentiate between vitreous and balanced salt solution (BSS) in real time.

Vitrectomy was performed in ex vivo porcine eyes across a range of vacuum levels and across available vitrectors on the Alcon Constellation. These measurements were repeated after vitrectomy in BSS. All surgeries were recorded and masked reviewers extracted the flow rates for each data point.

BSS flow rates were significantly higher (P<0.05) than vitreous flow rates except for 27-gauge at 20,000 cpm and 200 mmHg vacuum (P=0.093). As expected, higher cut rates, gauge, and vacuum corresponded to a higher flow rate. This allows clear differentiation between vitreous and BSS using flow rates as a guide.

Inflow rate is a dynamic measurement through the Alcon Constellation System that can give immediate feedback to the surgeon on the substrate they are removing, improving surgical efficiency.