Development trend and new understanding of contemporary vitrectomy_Chinese Journal of Ocular Fundus Diseases

Authors：

 Zhang Ming , Liu Yilin

Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu 610041, China;

Corresponding author：

Zhang Ming, Email: zhangmingscu@126.com

Keywords：

Vitrectomy; Surgical procedures, minimally invasive; Editorial

DOI：

10.3760/cma.j.cn511434-20221008-00528

Video：

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Vitrectomy is an important treatment for vitreoretinal diseases. After half a century of innovation and development, it has made a breakthrough from open type to micro-incision surgery. Minimally invasive vitrectomy has the advantages of wide indications and high cutting efficiency, which greatly improves the safety and efficacy of surgery, and minimizes the occurrence of trauma and complications during surgery. At present, with the development of surgical microscope system, ophthalmic microsurgery robot and other equipment, and the development and application of new artificial vitreous materials, vitrectomy is developing toward minimally invasive, accurate and intelligent development. The further development of vitrectomy innovative technology in the field of ophthalmology is hopeful in the future, so that clinicians can achieve the best surgical results with the minimum damage, and bring better light to patients.

Citation： Zhang Ming, Liu Yilin. Development trend and new understanding of contemporary vitrectomy. Chinese Journal of Ocular Fundus Diseases, 2022, 38(10): 789-792. doi: 10.3760/cma.j.cn511434-20221008-00528 Copy

1.	Machemer R, Buettner H, Parel JM. Vitrectomy, a pars plana approach. Instrumentation[J]. Mod Probl Ophthalmol, 1972, 10: 172-177.
2.	Machemer R, Parel JM, Buettner H. A new concept for vitreous surgery. Ⅰ. Instrumentation[J]. Am J Ophthalmol, 1972, 73(1): 1-7. DOI: 10.1016/0002-9394(72)90295-4.
3.	Kasner D, Miller GR, Taylor WH, et al. Surgical treatment of amyloidosis of the vitreous[J]. Trans Am Acad Ophthalmol Otolaryngol, 1968, 72(3): 410-418.
4.	Machemer R. The development of pars plana vitrectomy: a personal account[J]. Graefe's Arch Clin Exp Ophthalmol, 1995, 233(8): 453-468. DOI: 10.1007/BF00183425.
5.	O'Malley C, Heintz RM. Vitrectomy via the pars plana-a new instrument system[J]. Trans Pac Coast Otoophthalmol Soc Annu Meet, 1972, 53: 121-137.
6.	Thompson JT. Advantages and limitations of small gauge vitrectomy[J]. Surv Ophthalmol, 2011, 56(2): 162-172. DOI: 10.1016/j.survophthal.2010.08.003.
7.	Van Kuijk FJ, Uwaydatt S, Godley BF. Self-sealing sclerotomies in pars plana vitrectomy[J]. Retina, 2001, 21(5): 547-550. DOI: 10.1097/00006982-200110000-00027.
8.	Fujii GY, De Juan E Jr, Humayun MS, et al. A new 25-gauge instrument system for transconjunctival sutureless vitrectomy surgery[J]. Ophthalmology, 2002, 109(10): 1807-1813. DOI: 10.1016/s0161-6420(02)01179-x.
9.	Fujii GY, De Juan E Jr, Humayun MS, et al. Initial experience using the transconjunctival sutureless vitrectomy system for vitreoretinal surgery[J]. Ophthalmology, 2002, 109(10): 1814-1820. DOI: 10.1016/s0161-6420(02)01119-3.
10.	Eckardt C. Transconjunctival sutureless 23-gauge vitrectomy[J]. Retina, 2005, 25(2): 208-211. DOI: 10.1097/00006982-200502000-00015.
11.	Oshima Y, Wakabayashi T, Sato T, et al. A 27-gauge instrument system for transconjunctival sutureless microincision vitrectomy surgery[J]. Ophthalmology, 2010, 117(1): 93-102. DOI: 10.1016/j.ophtha.2009.06.043.
12.	Osawa S, Oshima Y. Innovations in 27-gauge vitrectomy for sutureless microincision vitrectomy surgery: duty cycle control and dual-port cutters may allow wider use of ultrasmall-gauge vitrectomy[J]. Retina Today, 2014: 42-45.
13.	Osawa S, Oshima Y. 27-Gauge vitrectomy[J]. Dev Ophthalmol, 2014, 54: 54-62. DOI: 10.1159/000360449.
14.	Yoneda K, Morikawa K, Oshima Y, et al. Surgical outcomes of 27-gauge vitrectomy for a consecutive series of 163 eyes with variousvitreous diseases[J]. Retina, 2017, 37(11): 2130-2137. DOI: 10.1097/IAE.0000000000001442.
15.	Gupta OP, Maguire JI, Eagle RC Jr, et al. The competency of pars plana vitrectomy incisions: a comparative histologic and spectrophotometric analysis[J]. Am J Ophthalmol, 2009, 147(2): 243-250. DOI: 10.1016/j.ajo.2008.08.025.
16.	Charles S, Ho AC, Dugel PU, et al. Clinical comparison of 27-gauge and 23-gauge instruments on the outcomes of pars plana vitrectomy surgery for the treatment of vitreoretinal diseases[J]. Curr Opin Ophthalmol, 2020, 31(3): 185-191. DOI: 10.1097/ICU.0000000000000659.
17.	Naruse Z, Shimada H, Mori R. Surgical outcomes of 27-gauge and 25-gauge vitrectomy day surgery for proliferative diabetic retinopathy[J]. Int Ophthalmol, 2019, 39(9): 1973-1980. DOI: 10.1007/s10792-018-1030-z.
18.	Haas A, Seidel G, Steinbrugger I, et al. Twenty-three-gauge and 20-gauge vitrectomy in epiretinal membrane surgery[J]. Retina, 2010, 30(1): 112-116. DOI: 10.1097/IAE.0b013e3181b32ebf.
19.	Yanyali A, Celik E, Horozoglu F, et al. 25-gauge transconjunctival sutureless pars plana vitrectomy[J] Eur J Ophthalmol, 2006, 16(1): 141-147. DOI: 10.1177/112067210601600123.
20.	Kadonosono K, Yamakawa T, Uchio E, et al. Comparison of visual function after epiretinal membrane removal by 20-gauge and 25-gauge vitrectomy[J]. Am J Ophthalmol, 2006, 142(3): 513-515. DOI: 10.1016/j.ajo.2006.03.060.
21.	Kovacević D, Antić IV, Valković A. Comparison of 23 gauge and 25 gauge PPV in the treatment of epiretinal membranes and macular holes[J]. Coll Antropol, 2014, 38(4): 1213-1216.
22.	Rizzo S, Barca F. Twenty-seven-gauge sutureless microincision vitrectomy surgery: a new frontier?[J]. Retina Today, 2013: 37-40.
23.	Jabbour J, Jabbour NM, Villers A, et al. 25-gauge vitrectomy[J]. Ophthalmology, 2007, 114(4): 827. DOI: 10.1016/j.ophtha.2006.12.009.
24.	Peterson SR, Silva PA, Murtha TJ, et al. Cataract surgery in patients with diabetes: management strategies[J]. Semin Ophthalmol, 2018, 33(1): 75-82. DOI: 10.1080/08820538.2017.1353817.
25.	Sharif-Kashani P, Nishida K, Pirouz Kavehpour H, et al. Effect of cut rates on fluidic behavior of chopped vitreous[J]. Retina, 2013, 33(1): 166-169. DOI: 10.1097/IAE.0b013e31825db758.
26.	Girard LJ, Nieves R, Hawkins RS. Ultrasonic fragmentation for vitrectomy and associated surgical procedures[J]. Trans Sect Ophthalmol Am Acad Ophthalmol Otolaryngol, 1976, 81(3 Pt 1): 432-450.
27.	Rizzo S, Fantoni G, Mucciolo DP, et al. Ultrasound in virecotomy: an alternative approach to traditional vitrectomy techniques[J]. Retina, 2020, 40(1): 24-32. DOI: 10.1097/IAE.0000000000002354.
28.	Abulon DJ, Buboltz DC. Porcine vitreous flow behavior during high-speed vitrectomy up to 7500 cuts per minute[J]. Transl Vis Sci Technol, 2016, 5(1): 7. DOI: 10.1167/tvst.5.1.7.
29.	Deuchler S, Knoch T, Papour A, et al. Pars plana vitrectomy-from suction cutting systems to ultrasound technology: vitesse-a new form of vitrectomy based on ultrasound technology[J]. Ophthalmologe, 2021, 118(7): 741-746. DOI: 10.1007/s00347-021-01377-6.
30.	Stanga PE, Williams JI, Shaarawy SA, et al. First-in-human clinical study to investigate the effectiveness and safety of pars plana vitrrctomoy surgery using a new hypersonic technology[J]. Retina, 2020, 40(1): 16-23. DOI: 10.1097/IAE.0000000000002365.
31.	Aznabaev BM, Dibaev TI, Mukhamadeev TR, et al. Twenty-five gauge ultrasonic vitrectomy: experimental and clinical performance analysis[J]. Retina, 2020, 40(7): 1443-1450. DOI: 10.1097/IAE.0000000000002863.
32.	de Smet MD, Naus GJL, Faridpooya K, et al. Robotic-assisted surgery in ophthalmology[J]. Curr Opin Ophthalmol, 2018, 29(3): 248-253. DOI: 10.1097/ICU.0000000000000476.
33.	Edwards TL, Xue K, Meenink HCM, et al. First-in-human study of the safety and viability of intraocular robotic surgery[J]. Nat Biomed Eng, 2018, 2: 649-656. DOI: 10.1038/s41551-018-0248-4.
34.	Jinno M, Li G, Patel N, Iordachita I. An Integrated High-dexterity Cooperative Robotic Assistant for Intraocular Micromanipulation[J/OL]. IEEE Int Conf Robot Autom, 2021, 2021: 10.1109/icra48506.2021. 9562040[2021-06-01]. https://pubmed.ncbi.nlm.nih.gov/34721938/. DOI: 10.1109/icra48506.2021.9562040.
35.	陈亦棋, 张超特, 洪明胜, 等. 辅助玻璃体视网膜显微手术机器人系统的研制及应用[J]. 中华实验眼科杂志, 2017, 35(1): 38-41. DOI: 10.3760/cma.j.issn.2095-0160.2017.01.008.Chen YQ, Zhao CT, Hong MS, et al. Development of cooperative robot-assistant surgery system for vitreoretinal microsurgery and its feasibility test in an animal model[J]. Chin J Pract Ophthalmol, 2017, 35(1): 38-41. DOI: 10.3760/cma.j.issn.2095-0160.2017.01.008.
36.	Ran R, Shi W, Gao Y, et al. Super-fast in situ formation of hydrogels based on multi-arm functional polyethylene glycols as endotamponade substitutes[J]. J Mater Chem B, 2021, 9(44): 9162-9173. DOI: 10.1039/d1tb01825f.
37.	Hayashi K, Okamoto F, Hoshi S, et al. Fast-forming hydrogel with ultralow polymeric content as an artificial vitreous body[J/OL]. Nature Biomedical Engineering, 2017, 2017: 0044[2017-03-09]. https://www.nature.com/articles/s41551-017-0044.
38.	Liu Z, Liow SS, Lai SL, et al. Retinal-detachment repair and vitreous-like-body reformation via a thermogelling polymer endotamponade[J]. Nat Biomed Eng, 2019, 3(8): 598-610. DOI: 10.1038/s41551-019-0382-7.
39.	Baker AEG, Cui H, Ballios BG, et al. Stable oxime-crosslinked hyaluronan-based hydrogel as a biomimetic vitreous substitute[J/OL]. Biomaterials, 2021, 271: 120750[2021-04-04]. https://pubmed.ncbi.nlm.nih.gov/33725584/. DOI: 10.1016/j.biomaterials.2021.120750.
40.	Wang T, Ran R, Ma Y, et al. Polymeric hydrogel as a vitreous substitute: current research, challenges, and future directions[J/OL]. Biomed Mater, 2021, 16(4): 042012[2021-06-11]. https://pubmed.ncbi.nlm.nih.gov/34038870/. DOI: 10.1088/1748-605X/ac058e.

1. Machemer R, Buettner H, Parel JM. Vitrectomy, a pars plana approach. Instrumentation[J]. Mod Probl Ophthalmol, 1972, 10: 172-177.
2. Machemer R, Parel JM, Buettner H. A new concept for vitreous surgery. Ⅰ. Instrumentation[J]. Am J Ophthalmol, 1972, 73(1): 1-7. DOI: 10.1016/0002-9394(72)90295-4.
3. Kasner D, Miller GR, Taylor WH, et al. Surgical treatment of amyloidosis of the vitreous[J]. Trans Am Acad Ophthalmol Otolaryngol, 1968, 72(3): 410-418.
4. Machemer R. The development of pars plana vitrectomy: a personal account[J]. Graefe's Arch Clin Exp Ophthalmol, 1995, 233(8): 453-468. DOI: 10.1007/BF00183425.
5. O'Malley C, Heintz RM. Vitrectomy via the pars plana-a new instrument system[J]. Trans Pac Coast Otoophthalmol Soc Annu Meet, 1972, 53: 121-137.
6. Thompson JT. Advantages and limitations of small gauge vitrectomy[J]. Surv Ophthalmol, 2011, 56(2): 162-172. DOI: 10.1016/j.survophthal.2010.08.003.
7. Van Kuijk FJ, Uwaydatt S, Godley BF. Self-sealing sclerotomies in pars plana vitrectomy[J]. Retina, 2001, 21(5): 547-550. DOI: 10.1097/00006982-200110000-00027.
8. Fujii GY, De Juan E Jr, Humayun MS, et al. A new 25-gauge instrument system for transconjunctival sutureless vitrectomy surgery[J]. Ophthalmology, 2002, 109(10): 1807-1813. DOI: 10.1016/s0161-6420(02)01179-x.
9. Fujii GY, De Juan E Jr, Humayun MS, et al. Initial experience using the transconjunctival sutureless vitrectomy system for vitreoretinal surgery[J]. Ophthalmology, 2002, 109(10): 1814-1820. DOI: 10.1016/s0161-6420(02)01119-3.
10. Eckardt C. Transconjunctival sutureless 23-gauge vitrectomy[J]. Retina, 2005, 25(2): 208-211. DOI: 10.1097/00006982-200502000-00015.
11. Oshima Y, Wakabayashi T, Sato T, et al. A 27-gauge instrument system for transconjunctival sutureless microincision vitrectomy surgery[J]. Ophthalmology, 2010, 117(1): 93-102. DOI: 10.1016/j.ophtha.2009.06.043.
12. Osawa S, Oshima Y. Innovations in 27-gauge vitrectomy for sutureless microincision vitrectomy surgery: duty cycle control and dual-port cutters may allow wider use of ultrasmall-gauge vitrectomy[J]. Retina Today, 2014: 42-45.
13. Osawa S, Oshima Y. 27-Gauge vitrectomy[J]. Dev Ophthalmol, 2014, 54: 54-62. DOI: 10.1159/000360449.
14. Yoneda K, Morikawa K, Oshima Y, et al. Surgical outcomes of 27-gauge vitrectomy for a consecutive series of 163 eyes with variousvitreous diseases[J]. Retina, 2017, 37(11): 2130-2137. DOI: 10.1097/IAE.0000000000001442.
15. Gupta OP, Maguire JI, Eagle RC Jr, et al. The competency of pars plana vitrectomy incisions: a comparative histologic and spectrophotometric analysis[J]. Am J Ophthalmol, 2009, 147(2): 243-250. DOI: 10.1016/j.ajo.2008.08.025.
16. Charles S, Ho AC, Dugel PU, et al. Clinical comparison of 27-gauge and 23-gauge instruments on the outcomes of pars plana vitrectomy surgery for the treatment of vitreoretinal diseases[J]. Curr Opin Ophthalmol, 2020, 31(3): 185-191. DOI: 10.1097/ICU.0000000000000659.
17. Naruse Z, Shimada H, Mori R. Surgical outcomes of 27-gauge and 25-gauge vitrectomy day surgery for proliferative diabetic retinopathy[J]. Int Ophthalmol, 2019, 39(9): 1973-1980. DOI: 10.1007/s10792-018-1030-z.
18. Haas A, Seidel G, Steinbrugger I, et al. Twenty-three-gauge and 20-gauge vitrectomy in epiretinal membrane surgery[J]. Retina, 2010, 30(1): 112-116. DOI: 10.1097/IAE.0b013e3181b32ebf.
19. Yanyali A, Celik E, Horozoglu F, et al. 25-gauge transconjunctival sutureless pars plana vitrectomy[J] Eur J Ophthalmol, 2006, 16(1): 141-147. DOI: 10.1177/112067210601600123.
20. Kadonosono K, Yamakawa T, Uchio E, et al. Comparison of visual function after epiretinal membrane removal by 20-gauge and 25-gauge vitrectomy[J]. Am J Ophthalmol, 2006, 142(3): 513-515. DOI: 10.1016/j.ajo.2006.03.060.
21. Kovacević D, Antić IV, Valković A. Comparison of 23 gauge and 25 gauge PPV in the treatment of epiretinal membranes and macular holes[J]. Coll Antropol, 2014, 38(4): 1213-1216.
22. Rizzo S, Barca F. Twenty-seven-gauge sutureless microincision vitrectomy surgery: a new frontier?[J]. Retina Today, 2013: 37-40.
23. Jabbour J, Jabbour NM, Villers A, et al. 25-gauge vitrectomy[J]. Ophthalmology, 2007, 114(4): 827. DOI: 10.1016/j.ophtha.2006.12.009.
24. Peterson SR, Silva PA, Murtha TJ, et al. Cataract surgery in patients with diabetes: management strategies[J]. Semin Ophthalmol, 2018, 33(1): 75-82. DOI: 10.1080/08820538.2017.1353817.
25. Sharif-Kashani P, Nishida K, Pirouz Kavehpour H, et al. Effect of cut rates on fluidic behavior of chopped vitreous[J]. Retina, 2013, 33(1): 166-169. DOI: 10.1097/IAE.0b013e31825db758.
26. Girard LJ, Nieves R, Hawkins RS. Ultrasonic fragmentation for vitrectomy and associated surgical procedures[J]. Trans Sect Ophthalmol Am Acad Ophthalmol Otolaryngol, 1976, 81(3 Pt 1): 432-450.
27. Rizzo S, Fantoni G, Mucciolo DP, et al. Ultrasound in virecotomy: an alternative approach to traditional vitrectomy techniques[J]. Retina, 2020, 40(1): 24-32. DOI: 10.1097/IAE.0000000000002354.
28. Abulon DJ, Buboltz DC. Porcine vitreous flow behavior during high-speed vitrectomy up to 7500 cuts per minute[J]. Transl Vis Sci Technol, 2016, 5(1): 7. DOI: 10.1167/tvst.5.1.7.
29. Deuchler S, Knoch T, Papour A, et al. Pars plana vitrectomy-from suction cutting systems to ultrasound technology: vitesse-a new form of vitrectomy based on ultrasound technology[J]. Ophthalmologe, 2021, 118(7): 741-746. DOI: 10.1007/s00347-021-01377-6.
30. Stanga PE, Williams JI, Shaarawy SA, et al. First-in-human clinical study to investigate the effectiveness and safety of pars plana vitrrctomoy surgery using a new hypersonic technology[J]. Retina, 2020, 40(1): 16-23. DOI: 10.1097/IAE.0000000000002365.
31. Aznabaev BM, Dibaev TI, Mukhamadeev TR, et al. Twenty-five gauge ultrasonic vitrectomy: experimental and clinical performance analysis[J]. Retina, 2020, 40(7): 1443-1450. DOI: 10.1097/IAE.0000000000002863.
32. de Smet MD, Naus GJL, Faridpooya K, et al. Robotic-assisted surgery in ophthalmology[J]. Curr Opin Ophthalmol, 2018, 29(3): 248-253. DOI: 10.1097/ICU.0000000000000476.
33. Edwards TL, Xue K, Meenink HCM, et al. First-in-human study of the safety and viability of intraocular robotic surgery[J]. Nat Biomed Eng, 2018, 2: 649-656. DOI: 10.1038/s41551-018-0248-4.
34. Jinno M, Li G, Patel N, Iordachita I. An Integrated High-dexterity Cooperative Robotic Assistant for Intraocular Micromanipulation[J/OL]. IEEE Int Conf Robot Autom, 2021, 2021: 10.1109/icra48506.2021. 9562040[2021-06-01]. https://pubmed.ncbi.nlm.nih.gov/34721938/. DOI: 10.1109/icra48506.2021.9562040.
35. 陈亦棋, 张超特, 洪明胜, 等. 辅助玻璃体视网膜显微手术机器人系统的研制及应用[J]. 中华实验眼科杂志, 2017, 35(1): 38-41. DOI: 10.3760/cma.j.issn.2095-0160.2017.01.008.Chen YQ, Zhao CT, Hong MS, et al. Development of cooperative robot-assistant surgery system for vitreoretinal microsurgery and its feasibility test in an animal model[J]. Chin J Pract Ophthalmol, 2017, 35(1): 38-41. DOI: 10.3760/cma.j.issn.2095-0160.2017.01.008.
36. Ran R, Shi W, Gao Y, et al. Super-fast in situ formation of hydrogels based on multi-arm functional polyethylene glycols as endotamponade substitutes[J]. J Mater Chem B, 2021, 9(44): 9162-9173. DOI: 10.1039/d1tb01825f.
37. Hayashi K, Okamoto F, Hoshi S, et al. Fast-forming hydrogel with ultralow polymeric content as an artificial vitreous body[J/OL]. Nature Biomedical Engineering, 2017, 2017: 0044[2017-03-09]. https://www.nature.com/articles/s41551-017-0044.
38. Liu Z, Liow SS, Lai SL, et al. Retinal-detachment repair and vitreous-like-body reformation via a thermogelling polymer endotamponade[J]. Nat Biomed Eng, 2019, 3(8): 598-610. DOI: 10.1038/s41551-019-0382-7.
39. Baker AEG, Cui H, Ballios BG, et al. Stable oxime-crosslinked hyaluronan-based hydrogel as a biomimetic vitreous substitute[J/OL]. Biomaterials, 2021, 271: 120750[2021-04-04]. https://pubmed.ncbi.nlm.nih.gov/33725584/. DOI: 10.1016/j.biomaterials.2021.120750.
40. Wang T, Ran R, Ma Y, et al. Polymeric hydrogel as a vitreous substitute: current research, challenges, and future directions[J/OL]. Biomed Mater, 2021, 16(4): 042012[2021-06-11]. https://pubmed.ncbi.nlm.nih.gov/34038870/. DOI: 10.1088/1748-605X/ac058e.

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Development trend and new understanding of contemporary vitrectomy

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