使用显微手术玻璃体切除工具的新型核心玻璃体牵引概率模型。
Novel probabilistic model of core vitreous traction using microsurgical vitrectomy tools.
机构信息
Department of Ophthalmology, Keck School of Medicine of the University of Southern California (USC), Los Angeles, CA, 90033, USA.
Department of Ophthalmology, Keck School of Medicine USC, Los Angeles, CA, 90033, USA.
出版信息
Graefes Arch Clin Exp Ophthalmol. 2021 Feb;259(2):405-412. doi: 10.1007/s00417-020-04836-z. Epub 2020 Aug 18.
PURPOSE
Traction exerted on the vitreous base during vitrectomy poses a risk for retinal tears. We aimed to quantify core vitreous traction during vitrectomy using spring return and pneumatic cutters.
METHODS
Juvenile porcine vitreous was vacuum held in a vitreous bath while traction was measured using precision force gauge during vitrectomy. The parameters included were aspiration rate, cut-rate, cutter size, and machine types.
RESULTS
An empirical probabilistic model was developed. The traction was proportional to the aspiration rate but insignificantly dependent on the cut-rate. The traction probability was inversely proportional to the exponential function of the traction (p < 0.05). The traction was < 0.003 N for 99% of the time using either 23- or 25-gauge cutters.
CONCLUSION
The tractions measured were considered similar to the causative forces of an iatrogenic retinal tear during a pars plana vitrectomy. The results provide a safety reference matrix of instrumental parameters during vitrectomy.
目的
玻璃体切除术对玻璃体基底部施加的牵引力会增加视网膜裂孔的风险。我们旨在使用弹簧回退和气动切割器来量化玻璃体切除术中的核心玻璃体牵引力。
方法
将幼年猪玻璃体在玻璃体浴中真空固定，同时在玻璃体切除术中使用精密力计测量牵引力。参数包括抽吸率、切割率、切割器尺寸和机器类型。
结果
开发了一个经验概率模型。牵引力与抽吸率成正比，但与切割率无关。牵引力的概率与牵引力的指数函数成反比（p<0.05）。使用 23 或 25 号穿刺器时，99%的时间牵引力<0.003 N。
结论
测量的牵引力被认为类似于在平面内玻璃体切除术期间医源性视网膜裂孔的致病力。该结果为玻璃体切除术中仪器参数提供了安全参考矩阵。
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