Hypersonic vitrectomy: a novel approach to vitreous removal

ABSTRACT Introduction Pars plana vitrectomy is the basis of modern retina surgery, and for the last 40 years, has been achieved using the pneumatic guillotine cutter. Recently, a new vitrectomy design has been developed: the hypersonic vitrector. This technology utilizes ultrasound energy to liquefy vitreous in contrast to the mechanical segmentation of vitreous strands that characterizes pneumatic cutters. Areas covered This review provides a history of the development of vitrectomy and summarizes the critical elements of effective and safe vitrectomy systems. The article will describe the novel hypersonic vitrectomy design, discuss what the initial pre-clinical and in-human studies tell us about its performance compared to standard pneumatic cutters, and considers its role in the future of retina surgery. Expert opinion Hypersonic vitrectomy is the first novel way to segment vitreous since the development of pneumatic guillotine cutters. It has the potential to make vitrectomy more efficient both by reducing operating times as well as enabling surgeons to remove silicone oil and retained lens material all with one instrument. With concurrent advancements in guillotine cutters, hypersonic vitrectomy has a high bar to clear to demonstrate advantages that would result in widespread adoption.