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The same tests were then performed using artificial vitreous humor as aspirating fluid. The average aspiration flow was calculated by averaging the measurement results of the different trials and the different vitreous cutters of the same type and gauge. The outer part has a closed distal end and the inner part an open distal end.
Future follow-up studies might usefully evaluate postoperative visual, anatomic, and safety outcomes.
– DORC Associate: a first look
The cup was placed on a high precision balance 0. In vitro evaluations were undertaken to assess volumetric aspiration flow rates the main outcome measure of a two-dimensional cutting vitrectome compared with a standard vitrectome of the same gauge. A prospective single-centre clinical study evaluated duration of core vitrectomy in 80 patients with macular pucker undergoing gauge or gauge vitrectomy using either a TDC vitrectome at 16, cuts per minute cpm or standard single-cut vitrectome, combined with a Valve Timing intelligence VTi pump system EVA, DORC International.
We evaluated overall vitrectomy cutting time in seconds required to remove core vitreous in 80 patients dorcc with macular pucker as part of a comparative evaluation of flow and operating duration using a TDC vitrectome and former standard single-cut vitrectome design gauge and gauge systems, DORC during core associatr procedures. If the higher double-cutting rate minimizes unwanted vitreous traction and reduces the risk of iatrogenic retinal damage is object of a safety designed ongoing study.
In vitro tests demonstrate that a more predictable and consistent flow of vitreous around the instrument probe is achieved using a TDC vitrectome compared with a regular vitrectome system. Faster operating times offer the potential of reduced costs as well quicker postoperative rehabilitation [ 14 ].
The concept of a double-cutting instrument for use in ophthalmic surgery was dogc patented in [ 4 ].
There is undoubtedly a surgical learning curve involved in mastering the technique of using small-gauge vitrectomy instruments, typically involving the first 20 or so cases. To evaluate comparative aspiration flow performance and also vitrectomy operating time efficiency using a double-cutting open port vitreous cutting system incorporated in a two-dimensional cutting TDC, DORC International vitrectome design versus standard vitreous cutter.
View at Google Scholar F. The port diameter of this new TDC vitrectome is larger than previous vitrectome designs for the gauge TDC vitrectome, e. Asssociate vitreous enters the inner aperture, it is cut first in a forward motion and then again during the backward motion. During a cycle in which the inner part performs a back-and-forth movement in the outer part, a cutting movement occurs twice.
Time measurement of core vitrectomy duration was made by a secondary person without a need to change standard vitrectomy procedures of PPV for epiretinal membrane removal. A principal goal in PPV is to minimize vitreous traction by removing only the target ocular tissue, without inadvertently drawing unwanted tissue into the vitrectomy probe port or creating distant traction that might cause iatrogenic retinal tears or other complications.
Journal of Ophthalmology
Results suggest significantly decreased operating time for core vitrectomy. A prospective single-centre clinical study assessed duration of core vitrectomy procedure using a TDC vitrectome versus a standard single-cut guillotine vitrectome; the results reveal shorter operating times using a double-cutting TDC vitrectomy probe. We report below the methodologies and findings from in vitro comparisons of aspiration flow dynamics utilizing TDC and standard vitrectomes connected to different surgical platforms, together with methods and results of a prospective surgical case series study evaluating duration of core vitrectomy procedures and therefore comparative flow efficiency performance, using a TDC vitrectome system versus standard vitreous cutter system.
The general principle of pars plana vitrectomy PPV surgery is to ensure complete vitreous removal with no residual vitreous left following the procedure.
Table 2 tabulates the assoxiate duration of core vitrectomy procedures for each surgical intervention group assessed. Early gauge vitrectomy systems were marked by reduced fluid flow and longer vitrectomy duration compared with gauge systems [ 9 ]. However, enlarging the port diameter of a vitreous cutter to increase flow becomes less effective as the port becomes larger [ 2 ]. This is an open access article distributed under the Creative Commons Attribution Licensewhich permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
The degree of retinal traction created by axsociate cutters is influenced by the effect of time of aspiration, distance from the retina, and cutting rate.
Associate – Rumex Baltics
Experimental assessments show maintenance of constant high aspiration flow independent of cutter speed using a two-dimensional cutting TDC vitrectome for vitreous removal. Statistical significance value of comparison between PPV durations performed using standard and TDC vitreous cutters was set at 0. A cut rate and a vacuum level were set on asscoiate EVA machine according to the following range of tested settings: Company Information Contact the company for additional information, availability, or pricing: Associate Dual allows for flow controlled vitrectomy and vacuum controlled high speed vitrectomy.
In the comparative case series clinical study, the mean duration of core vitrectomy procedures using gauge and gauge TDC vitreous cutter system was statistically significantly shorter than the mean operating duration for core PPV performed utilizing a standard single-cut vitrectome of the same gauge.
To receive news and publication updates sssociate Journal of Ophthalmology, enter your email address in the box below. Time and flow data were analyzed using linear least squares regression analyses and two-tailed -tests. Mean duration of core vitrectomy operating time for gauge and gauge surgeries utilizing either a standard single-cut or a TDC associqte.
Size 20, 23, 25, 27 gauge. Max Vaccum Not specified. Trending in Retina Powered by: The principal advantages of this novel guillotine sleeve design included a doubling of cut rate, increased flow, and potentially decreased retinal traction or force exerted by the probe.
After activation of the vitreous cutter, a small time was allowed for attainment of a constant vacuum level in the aspiration tubing.
The information contained on Beye. Megatron Cool Geuder AG. Before each test, a priming procedure was performed to ensure that the aspiration tubing of the cutter was completely filled with water and that the cutter was positioned with its tip into a cup filled with fluid.
In the author in cooperation with DORC International developed a newer vitrectome design, introducing a modified vitreous cutter technology called two-dimensional cutting TDC vitrectome system, launched in conjunction with the EVA ophthalmic surgical platform, a new aspiration system designed to provide both flow and vacuum control mode vitrectomy for enhanced intraoperative fluidics stability.
At-a-Glance Dual system, phaco and vitrectomy Twin pump system, peristaltic and venturi Programmable dual linear footswitch. Fluidic stability and control during vitrectomy is essential. Vitrectomy surgery performed using a TDC vitrectome was faster than core vitrectomy utilizing a standard single-action vitrectome dotc similar cut speeds.