Efficiency and safety comparison between 20,000 and 10,000 cuts per minute vitrectomy using a 27G cutter in rhegmatogenous retinal detachment: a prospective randomized controlled study.
Yu-Te Huang, I Wang, Po-Yu Chen, Chi-Lan Yang, San-Ni Chen
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Abstract
Purpose: To compare the efficac and safety of a dual-blade 20,000 cuts per minute (cpm) vitrectomy probe with a single-blade 10,000 cpm probe for primary rhegmatogenous retinal detachment (RRD).
Study design: Prospective, randomized controlled clinical trial.
Methods: Evaluations were conducted preoperatively, intraoperatively, and at three months postoperatively. The main outcome measure focused on the duration of core vitrectomy, with secondary outcomes including peripheral vitreous shaving duration, balanced salt solution (BSS) consumption, anatomical and functional outcomes, as well as the incidence of surgical procedure-related complications.
Results: Overall, 35 cases in the 20,000 cpm group and 37 cases in the 10,000 cpm group completed the trial without significant differences in baseline demographic characteristics. The 20,000 cpm group demonstrated significantly shorter core vitrectomy duration (161.6 ± 10.4 vs. 206.8 ± 10.1 s) (P = 0.003) and peripheral vitreous shaving time (446.3 ± 20.3 vs. 544.2 ± 22.2 s) (P = 0.002) compared to the 10,000 cpm group. BSS consumption was higher in the 20,000 cpm group but without statistical significance (P = 0.231). There were no significant differences in the need for scleral sutures and the incidence of iatrogenic retinal breaks (P = 0.331 and 0.523). At the 3-month follow-up, there were no statistically significant differences in primary success, final anatomical success, or mean visual acuity (P > 0.9, P = 0.326). Rates of complications, including ocular hypertension, epiretinal membrane formation, and endophthalmitis also showed no statistically significant differences (P > 0.6).
Conclusion: The utilization of the new-generation 27-gauge system with a 20,000 cpm probe may herald a new paradigm of high-flow, smaller-diameter instrumentation, thereby enhancing the efficiency of the small gauge technique.
期刊介绍：
The Japanese Journal of Ophthalmology (JJO) was inaugurated in 1957 as a quarterly journal published in English by the Ophthalmology Department of the University of Tokyo, with the aim of disseminating the achievements of Japanese ophthalmologists worldwide. JJO remains the only Japanese ophthalmology journal published in English. In 1997, the Japanese Ophthalmological Society assumed the responsibility for publishing the Japanese Journal of Ophthalmology as its official English-language publication.
Currently the journal is published bimonthly and accepts papers from authors worldwide. JJO has become an international interdisciplinary forum for the publication of basic science and clinical research papers.
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