Inoue Makoto, Abulon Dina Joy K, Hirakata Akito
Kyorin Eye Center, School of Medicine, Kyorin University, Tokyo, Japan.
Alcon Research, Ltd., Irvine, CA, USA.
Clin Ophthalmol. 2014 Nov 19;8:2307-18. doi: 10.2147/OPTH.S72375. eCollection 2014.
To compare the effects of different 23- and 25-gauge microincision vitrectomy trocar cannula entry systems on incision architecture.
We tested one ridged microvitreoretinal (MVR), one non-ridged MVR, one pointed beveled, and one round-tipped beveled blade (n=10 per blade design per incision type). Each blade's straight and oblique incision architecture was assessed in a silicone disc simulating the sclera. Wound leakage under pressure and endoscopic observations were conducted on sclerotomy sites of isolated porcine eyes (n=4 per blade design) after simulated vitrectomy.
Differences in blade design created distinct incision architecture. Incisions were linear with the ridged MVR blade, flattened "M-shaped" with the non-ridged MVR blade, asymmetrical chevron-shaped with the pointed beveled blade, and curved with the round-tipped beveled blade. With the exception of oblique entry incision thickness, both MVR blade designs created thinner incisions than the beveled blades at entry and exit sites. Only the ridged MVR blade created incisions with no leakage. Vitreous incarceration was observed with all trocar cannula systems.
Wound closure in porcine eyes was similar with all blades despite differences in incision architecture. Wound leakage occurred at low to moderate infusion pressures with most blades; no wound leakage was observed with ridged MVR blades.
比较不同23号和25号微切口玻璃体切割套管穿刺系统对切口结构的影响。
我们测试了一种有脊微玻璃体视网膜（MVR）刀片、一种无脊MVR刀片、一种尖斜角刀片和一种圆头斜角刀片（每种切口类型的每种刀片设计n = 10）。在模拟巩膜的硅胶盘中评估每种刀片的直线和斜向切口结构。在模拟玻璃体切割术后，对离体猪眼的巩膜切开部位（每种刀片设计n = 4）进行加压下伤口渗漏和内镜观察。
刀片设计的差异产生了不同的切口结构。有脊MVR刀片的切口呈线性，无脊MVR刀片的切口呈扁平“M形”，尖斜角刀片的切口呈不对称人字形，圆头斜角刀片的切口呈弯曲状。除了斜向穿刺切口厚度外，两种MVR刀片设计在穿刺入口和出口部位形成的切口都比斜角刀片薄。只有有脊MVR刀片形成的切口无渗漏。所有套管系统均观察到玻璃体嵌顿。
尽管切口结构不同，但所有刀片在猪眼中的伤口闭合情况相似。大多数刀片在低至中等输注压力下出现伤口渗漏；有脊MVR刀片未观察到伤口渗漏。
