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Innovation in ophthalmology: a new tool to avoid a common complication in eye surgery

Innovation en ophtalmologie : un nouvel outil pour éviter une complication courante en chirurgie oculaire

A team made up of researchers and clinicians from the Centre de recherche de l’Hôpital Maisonneuve-Rosemont (CR-HMR) and the Centre universitaire d’ophtalmologie (CUO) of the Hôpital Maisonneuve-Rosemont (HMR), part of the CIUSSS de Est-de-l'Île-de-Montréal and affiliated with the Université de Montréal, have developed an innovative method, the Smart vitrector, to prevent a common complication in eye surgery. The results of their work have just been published in the journal Translational Vision Science & Technology. The first author of this study is Alexandre Abid, doctoral student in biomedical engineering.

The laboratory team of Dr Christos Boutopoulos, PhD from CR-HMR and two retinal surgeons from CUO, Drs Renaud Duval and Flavio Rezende, have in fact developed a method to reduce accidental retinal injuries in vitrectomy, a surgical technique involving the removal of the vitreous gel from the eye in order to gain access to the retina.

 

An innovation in response to a clinical need

Iatrogenic retinal breaks (disorders caused by a medical procedure) are possible complications during surgery. A subset of those breaks is caused by accidental cuts of the retina by a surgical tool called the vitrector. This type of injury, which compromises the effectiveness and success of surgery, occurs in more difficult cases and is more common in novice surgeons.

The problem was submitted to the laboratory of Dr Boutopoulos, Ph. D., in 2017 by Dr Duval in order to find a solution to avoid this common complication in eye surgery.

 

The Smart vitrector, a system for preventing retinal damage

The CR-HMR research team invented a solution that uses laser technology. The researchers integrated a miniaturized fiber-optic sensor into a vitrector and used an imaging technology known as optical coherence tomography to detect the onset of accidental retinal damage. The system also includes a risk detection algorithm that automatically terminates the vitrector cutting function to prevent accidental retinal injury. The tool's safety module therefore helps eye surgeons prevent retinal injuries just as a car's collision avoidance system helps motorists avoid accidents.

The system has been validated with experimental surgeries in swine and has been shown to prevent or mitigate most intentionally attempts at creating damage to the retina. Potential clinical adoption of the Smart vitrector could reduce the incidence of iatrogenic complications of vitrectomy and thus increase the therapeutic outcome of the surgery. The team is now focusing on commercializing this technology.

 

To read the full article

Alexandre Abid, Renaud Duval, Flavio Rezende, Christos Boutopoulos; A Smart Vitrector Equipped by a Fiber-Based OCT Sensor Mitigates Intentional Attempts at Creating Iatrogenic Retinal Breaks During Vitrectomy in Pigs. Trans. Vis. Sci. Tech. 2021;10(13):19.