Klaus Lucke, Silvia Bopp Bremen, Germany

Venturi vacuum systems have become the gold standard in vitrectomy machines, due to their rapid and linear response to foot pedal depression. However, in close proximity to the retina they constitute a high risk as uncontrolled flow can result in inadvertent engagement of retinal tissue resulting in unwanted tear formation. High speed shaving systems have been developed to control the flow, however they suffer from low efficiency. Roller pump systems with linear control of the flow rate are a good alternative option giving the surgeon more precise control over the vitrectomy particularly in the vitreous base.

We have been using a system that offers a free choice between these two principles and have found that both methods offer distinct advantages in certain situations. Whereas we prefer flow control in vitrectomy of the vitreous base, the venturi system is more effective at performing posterior vitreous detachments and purposely cutting the peripheral retina near the ora serrata in macular rotation surgery.

The principles and exemplary surgical methods are demonstrated in video sequences.