Clinical Performance and Outcomes of a 20 000 Cuts-per-Minute, 25-Gauge, Beveled-Tip Vitrectomy Probe

Purpose: To report the clinical outcomes and instrument performance of a 25-gauge, 20 000 cuts-per-minute (cpm), beveled-tip vitrectomy probe system. Methods: This prospective consecutive case series comprised eyes having primary pars plana vitrectomy (PPV) using a 20 000 cpm vitrectomy probe system (20 000 cpm group). The main outcome measures were the rate of success, operative times, number of steps, 3-month distance-corrected visual acuity (DCVA), ancillary instruments use, and adverse events (AEs). A comparative analysis with the results of a previously published series of eyes that had PPV with a 10 000 cpm, beveled-tip vitrectomy system (10 000 cpm group) was performed. Results: The study included 55 eyes. The surgical objectives were attained in all eyes. The mean logMAR DCVA improved from 0.96 preoperatively to 0.35 postoperatively (at 3 months) (P < .0001). The mean (±SD) total operative time, core vitrectomy time, shave vitrectomy time, and total vitrectomy time was 1964.27 ± 846.92 seconds, 174.87 ± 116.23 seconds, 478.41 ± 387.30 seconds, and 655.60 ± 397.53 seconds, respectively. The mean number of surgical steps was 4.05 ± 1.06 and of ancillary instrument exchanges, 3.23 ± 1.89. The mean postoperative day 1 pain score was 0.16 ± 0.46. Two eyes had elevated intraocular pressure postoperatively and 1 eye had hypotony. There were fewer ancillary instrument exchanges (P < .001) and fewer AEs (P = .044) in the 20 000 cpm group than in the 10 000 cpm group. Conclusions: Both the 20 000 and 10 000 systems are effective and safe for the treatment of various vitreoretinal indications. The potential advantages of the 20 000 system include reduced use of ancillary instrumentation and lower AE rates.