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Surgery with New MVR-style Cannulas and LEDStar Endoillumination

Peter Szurman, Prof. Dr. Med., Knappschaft-Augenklinik, Sulzbach, Germany, discusses early surgical experience using one-step microvitreoretinal (MVR) trocar-cannulas for microincision transconjunctival sutureless vitrectomy and enhanced endoillumination using LED light source technology.

The one-step microvitreoretinal cannula system (DORC International) features a modified MVR blade requiring reduced piercing force on initial entry and a new closure valve that provides enhanced visibility when entering instruments. A hollow-shaped stiletto-style blade with ultrasharp tip creates a flat slit-style incision, with no need for closure plugs due to a novel closure valve that helps create a closed surgical globe with constant intraocular pressure.

Watertight sclerotomies using stiletto-style 1-step trocar system

“Initial insertion of the tapered stiletto-style MVR trocar-cannula system is very smooth and the one-step blade trocar allows for better wound closure, watertight sclerotomies, and a lowered incidence of postoperative hypotony,” explained Prof. Szurman.

Having previously adopted the conventional two-step system that incorporates a separate MVR blade and blunt tip inserter, Prof. Szurman said that the one-step MVR trocar-cannula system is now his preferred solution, providing excellent blade sharpness for better wound construction and more efficient overall microincision vitrectomy surgery.

LED illumination provides far brighter enhanced tissue visualization, with optimum safety

The LEDStar illumination system is a long-life LED-endoillumination module that offers powerful light intensity, maximum illumination up to 40 lumen intensity, without any phototoxic ultraviolet or infrared light. There are three independent output sockets with individually adjustable intensity via touch screen mode, permitting light emission in 20 individually adjustable color grades from white to yellow. A wide variety of compatible light probe designs are available in 20-, 23-, 25- and 27-gauge, providing a selection to suit specific case indications and surgeon preference.

Penetration force & wound construction test
Test results show DORC’s one-step cannula system creates the lowest insertion force in comparison to other tested cannula systems, creating a straight-cut incision for optimal wound construction and self-sealing. Source: DORC International

Prof. Szurman commented, “While advances in endoillumination have accompanied the move to small-gauge vitrectomy surgery, bright tissue visualization and avoidance of retinal toxicity remain important surgical considerations.

“The LEDStar illumination system has three distinct advantages: highest available light intensity, individual adjustable color grades for safer retinal protection, and integration of LED illumination technology with the EVA VacuFlow VTi aspiration system, an advanced fluid control system for vitreoretinal and/or cataract surgery. In my experience, the LEDStar system for endoillumination provides the brightest light intensity available for small-gauge vitrectomy surgery, with the ability to individualize the use of specific light colors, minimizing the risk of retinal light toxicity.” ■