title: Ultrastructural and histopathologic findings after pars plana vitrectomy with a new hypersonic vitrector system. Qualitative preliminary assessment.
abstract: OBJECTIVE
  Preliminary assessment of a new prototype ultrasound-based hypersonic vitrector (HV) by qualitatively examining the histopathological changes in the retina and vitreous body after pars plana vitrectomy (PPV) and its ability to fragment vitreous collagen.
  
  
  METHODS
  Fourteen porcine cadaveric eyes, 20 eyes in live swine and six human cadaveric eyes underwent PPV using the HV or a pneumatic guillotine vitrector (GV). An additional 4 porcine crystalline lenses were touched with either the HV or GV for 1 minute. Following PPV, human vitreous was removed and processed for electron microscopy (EM). Eyes and lenses were fixed and sectioned for light microscopy (LM).
  
  
  RESULTS
  There were no macroscopic retinal or optic nerve defects associated with either HV or GV PPVs. Cadaveric retinal specimens showed separation of the inner limiting membrane (ILM) and vacuolization and fragmentation at the nerve fiber layer (NFL) and the ganglion cell layer (GCL). ILM fragmentation and separation were found after PPV in live swine with both vitrectors. Small disruptions of the posterior capsule or structural lens defects were found after HV touch. The EM analysis revealed more fragmentation of human vitreous collagen fibrils after HV compared to GV PPV.
  
  
  CONCLUSIONS
  LM and EM analysis of retina, vitreous, and crystalline lens after PPV showed similar morphological changes using the HV or the GV. Vitreous fragmentation appeared more effective with the HV. Overall this study suggests that the HV may be a promising new technology. More work is needed to quantitatively assess its safety and efficacy.
authors.affiliation: Manchester Royal Eye Hospital, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom.|Manchester Vision Regeneration (MVR) Lab at Manchester Royal Eye Hospital and NIHR/ Wellcome Trust Manchester CRF, Manchester, United Kingdom.
authors.forename: Salvador
authors.identifier: http://orcid.org/0000-0002-6463-4227
authors.initials: S
authors.lastname: Pastor-Idoate
authors.affiliation: Manchester Royal Eye Hospital, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom.|National Specialist Ophthalmic Pathology Service, Manchester Royal Eye Hospital, Manchester, United Kingdom.
authors.forename: Richard
authors.initials: R
authors.lastname: Bonshek
authors.affiliation: Manchester Royal Eye Hospital, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom.|National Specialist Ophthalmic Pathology Service, Manchester Royal Eye Hospital, Manchester, United Kingdom.
authors.forename: Luciane
authors.initials: L
authors.lastname: Irion
authors.affiliation: Manchester Royal Eye Hospital, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom.|Eye Bank, Manchester Royal Eye Hospital, Manchester, United Kingdom.
authors.forename: Isaac
authors.initials: I
authors.lastname: Zambrano
authors.affiliation: Manchester Royal Eye Hospital, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom.|Operating Theatre Services, Manchester Royal Eye Hospital, Manchester, United Kingdom.
authors.forename: Paul
authors.initials: P
authors.lastname: Carlin
authors.affiliation: Electron Microscopy Core Facility, Faculty of Life Sciences, University of Manchester, Manchester, United Kingdom.
authors.forename: Aleksandr
authors.initials: A
authors.lastname: Mironov
authors.affiliation: Manchester Royal Eye Hospital, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom.|Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom.
authors.forename: Paul
authors.initials: P
authors.lastname: Bishop
authors.affiliation: Manchester Royal Eye Hospital, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom.|Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom.
authors.forename: David
authors.initials: D
authors.lastname: McLeod
authors.affiliation: Manchester Royal Eye Hospital, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom.|Manchester Vision Regeneration (MVR) Lab at Manchester Royal Eye Hospital and NIHR/ Wellcome Trust Manchester CRF, Manchester, United Kingdom.|Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom.
authors.forename: Paulo Eduardo
authors.initials: PE
authors.lastname: Stanga
mesh_terms: D000328:Adult; D000368:Aged; D000818:Animals; D002102:Cadaver; D003094:Collagen / Q000378:metabolism; D006801:Humans; D007908:Lens, Crystalline / Q000473:pathology / Q000601:surgery / Q000648:ultrastructure; D046529:Microscopy, Electron, Transmission; D008875:Middle Aged; D023421:Models, Animal; D009900:Optic Nerve / Q000473:pathology / Q000648:ultrastructure; D036301:Qualitative Research; D012160:Retina / Q000473:pathology* / Q000601:surgery* / Q000648:ultrastructure; D034421:Sus scrofa; D014463:Ultrasonography; D014821:Vitrectomy / Q000295:instrumentation*; D014822:Vitreous Body / Q000473:pathology* / Q000601:surgery* / Q000648:ultrastructure
chemical_list: D003094:Collagen