Experimental Application of Piezoelectric Actuator-Driven Pulsed Water Jets in Retinal Vascular Surgery
Experimental Application of Piezoelectric Actuator-Driven Pulsed Water Jets in Retinal Vascular Surgery
复制标题
压电驱动器驱动脉冲水射流在视网膜血管手术中的实验应用
DOI：
10.1167/tvst.3.6.10
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发表时间：
2014
期刊：
影响因子：
--
通讯作者：
Nakazawa T.
中科院分区：
文献类型：
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作者：
Kunikata H;Tanaka Y;Aizawa N;Nakagawa A;Tominaga T;Nakazawa T.
用途：为了报告眼科压电致动器驱动的脉冲水射流（ADPJ）系统适用于intraocular use.Methods的有效性和安全性：：首先，我们确定了最高ADPJ流速，不会导致不安全的上升，术中眼内压（IOP）在兔子（n= 4）。接下来，我们确定了在该流速下最有效的ADPJ频率（以赫兹为单位）。最后，我们可视化ADPJ流，测量其压力，并确定ADPJ针与视网膜静脉之间的最小电压和距离，以通过按摩视网膜外血管诱导血柱静脉内移位（DBC）（n= 3），同时不引起视网膜撕裂或出血。我们发现，0.05 mL/min的ADPJ流速导致IOP在1分钟后升高至40 mm Hg以上，但在0.025 mL/min时，IOP甚至在3分钟后仍保持在40 mm Hg以下。此外，我们发现，0.025mL/min的ADPJ流在10 Hz的脉冲频率下是稳定的，并且在该流速/频率下ADPJ压力与所施加的电压密切相关（P< 0.001，r2 = 0.9991）。在不引起视网膜撕裂或出血的情况下实现静脉内DBC的最小电压和距离分别为40 V和0.5 mm。结论：：在适当的流速和手术时间下，ADPJ成功地诱导了视网膜血管和静脉内DBC的按摩，同时保持安全的IOP，不引起视网膜并发症。ADPJ系统有望作为一种安全、微创的工具用于人类视网膜血管疾病的眼内手术治疗。
Purpose:: To report on the effectiveness and safety of an ophthalmic piezoelectric actuator-driven pulsed water jet (ADPJ) system adapted for intraocular use.Methods:: First, we determined the highest ADPJ flow rate that did not cause an unsafe rise in intraoperative intraocular pressure (IOP) in rabbits (n= 4). Next, we determined the most effective ADPJ frequency (in hertz) at that flow rate. Finally, we visualized the ADPJ stream, measured its pressure, and determined the minimum voltage and distance between the ADPJ needle and retinal veins to induce intravenous displacement of the blood column (DBC) through massage of the outer retinal vessels (n= 3) while not causing retinal tearing or hemorrhage.Results:: We found that a 0.05 mL/min ADPJ flow rate caused IOP to rise above 40 mm Hg after 1 minute, but that at 0.025 mL/min, IOP stayed below 40 mm Hg even after 3 minutes. Moreover, we found that a 0.025 mL/min ADPJ stream was stable at a pulse frequency of 10 Hz and that at this flow rate/frequency the ADPJ pressure was closely correlated with the applied voltage (P< 0.001, r 2= 0.9991). The minimum voltage and distance to achieve intravenous DBC without causing retinal tearing or hemorrhage were 40 V and 0.5 mm, respectively.Conclusions:: With an appropriate flow rate and surgical time, ADPJ successfully induced massage of the retinal vessels and intravenous DBC while maintaining safe IOP and not causing retinal complications.Translational Relevance:: The ADPJ system has promise as a safe and minimally invasive instrument for the intraocular surgical treatment of human retinal vascular diseases.