Ultrastructural and histopathologic findings after pars plana vitrectomy with a new hypersonic vitrector system. Qualitative preliminary assessment
Ultrastructural and histopathologic findings after pars plana vitrectomy with a new hypersonic vitrector system. Qualitative preliminary assessment
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DOI：
10.1371/journal.pone.0173883
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发表时间：
2017-04-11
期刊：
影响因子：
3.7
通讯作者：
Stanga, Paulo Eduardo
中科院分区：
文献类型：
--
作者：
Pastor-Idoate, Salvador;Bonshek, Richard;Stanga, Paulo Eduardo
PurposePreliminary assessment of a new prototype ultrasound-based hypersonic vitrector（HV）by quantitatively examining the histopathological changes in retina and vitreous body after pars plana vitrectomy（PPV）and its capability to fragment vitreous colloid.Methods14只猪尸眼，20只活体猪眼和6只人尸眼进行PPV using the HV or a pneumatic guillotine vitrector（GV）.用HV或GV接触另外4个猪晶状体1分钟。PPV后，取出人玻璃体并进行电子显微镜检查（EM）。眼睛和晶状体被固定和切片光学显微镜（LM）。ResultsThere没有宏观视网膜或视神经缺损与HV或GV PPV。尸体视网膜标本显示内界膜（ILM）分离，神经纤维层（NFL）和神经节细胞层（GCL）空泡化和碎裂。在活体猪的玻璃体切除术后，观察到ILM断裂和分离。HV触摸后发现后囊膜或结构性透镜缺陷的小破裂。EM分析显示，更多的碎片人类玻璃体胶原纤维HV后GV PPV。ConclusionsLM和EM分析的视网膜，玻璃体，和晶体透镜PPV后显示出类似的形态学变化，使用HV或GV。玻璃体破碎似乎更有效的HV。总的来说，这项研究表明，HV可能是一种有前途的新技术。需要做更多的工作来定量评估其安全性和有效性。
PurposePreliminary 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.MethodsFourteen 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).ResultsThere 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.ConclusionsLM 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.