Comparison of erbium:yttrium-aluminum-garnet-laser vitrectomy and mechanical vitrectomy: a clinical study.
OBJECTIVE
To evaluate the clinical usefulness of the erbium:YAG (yttrium-aluminum-garnet) laser for vitrectomy and to compare it with a conventional mechanical vitrectomy system regarding the intraoperative parameters.


METHODS
Prospective, randomized, clinical trial.


METHODS
Thirty eyes of 30 patients underwent vitrectomy, 15 eyes in each group.


METHODS
For mechanical vitrectomy, a commercially available vitrectomy unit was used. The operating parameters, cutting rate (7 Hz = 420 cpm), maximal suction force (300 mmHg), and aspiration flow (20 ml/min), were held constant. A newly developed erbium (Er):YAG laser unit and handpiece was used for laser vitrectomy with predetermined parameters for cutting rate (70 Hz = 4200 cpm), maximal suction force (50 mmHg), and aspiration flow (20 ml/min). Surgery parameters were recorded in real time and the operation was video recorded. The clinical follow-up time was a minimum of 3 months (average, 6.2 months; range, 3-9 months).


METHODS
The surgery time was comparable in both groups. During Er:YAG laser vitrectomy, the average suction force was significantly reduced (P< 0.001) compared with that during mechanical vitrectomy. The mean-square variation in suction as a measure to quantify the forces acting on intraocular structures during surgery was significantly smaller in the Er:YAG laser vitrectomy group (P << 0.001).


CONCLUSIONS
Erbium:YAG laser vitrectomy may provide a semicontinuous procedure. This technique minimizes periodical intraoperative forces and movements of intraocular structures and may provide, therefore, a safer vitrectomy.
Petersen
H
H
Department of Ophthalmology, University of Dresden, Dresden, Germany.
Mrochen
M
M
Seiler
T
T
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053685:Laser Therapy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012164:Retinal Diseases / Q000601:surgery*; D016896:Treatment Outcome; D014821:Vitrectomy / Q000295:instrumentation / Q000379:methods*; D014823:Vitreous Hemorrhage / Q000601:surgery*