Eye Concepts, Doheny Eye Institute, Los Angeles, CA 90033-4500, USA.
Invest Ophthalmol Vis Sci. 2010 Aug;51(8):4181-6. doi: 10.1167/iovs.09-4852. Epub 2010 Feb 24.
The purpose of this study was to use a novel method to quantify the traction applied to the retina during vitrectomy.
Five 20-gauge electric cutters were used. Fresh porcine eyes were positioned in a specially developed holder and transfixed to the retinal layers with a microwire, and the other end was fixed to the load cell of a strain gauge. The cutter to be assessed was introduced into the eye by a micromanipulator at a 45 degrees angle adjacent to the retina. The traction force was evaluated when the cutter was at 3 and 5 mm from the retina. As control, the experiment was repeated in eyes filled with water, and the results were compared to those when the eyes had vitreous gel.
Results from the eyes with vitreous gel indicate that retinal traction increased with increasing aspiration vacuum (7.90 dyn for each 100 mm Hg increased; P < 0.05) and proximity to the retina (2.17 dyn; P < 0.05) and decreased with increasing cut rate (2.51 dyn for each 500 cuts per minute increased; P < 0.05). In all eyes filled with water, traction was not observed.
The present study establishes a new reproducible technique to quantify vitreoretinal traction during vitrectomy and demonstrates that the effects of aspiration, distance from the retina, and cut rate are crucial factors in the amount of retinal traction created by vitreous cutters.
本研究旨在使用一种新方法来量化玻璃体切割术中对视网膜施加的牵引力。
使用了 5 个 20 号电切刀。新鲜猪眼被放置在一个特制的固定器中,并用微丝固定在视网膜层上,另一端固定在应变计的称重传感器上。将待评估的切割器通过微操纵器以 45 度角引入眼睛,使其与视网膜相邻。当切割器距离视网膜 3 毫米和 5 毫米时,评估牵引力。作为对照,在充满水的眼睛中重复了该实验,并将结果与含有玻璃体凝胶的眼睛进行了比较。
含有玻璃体凝胶的眼睛的结果表明,视网膜牵引力随着抽吸真空度的增加而增加(每增加 100 毫米汞柱增加 7.90 dyn;P < 0.05)和接近视网膜的程度(2.17 dyn;P < 0.05)而增加,并随着切割速度的增加而减少(每分钟增加 500 次切割时增加 2.51 dyn;P < 0.05)。在所有充满水的眼睛中,都没有观察到牵引力。
本研究建立了一种新的可重复技术,用于量化玻璃体切割术中的玻璃体视网膜牵引力,并表明抽吸、距视网膜的距离和切割速度的影响是玻璃体切割器产生视网膜牵引力的关键因素。