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Bausch & Lomb's Millennium Vitrectomy Enhancer
LESLIE GOLDBERG, ASSOCIATE EDITOR
The Bausch & Lomb Millennium Vitrectomy Enhancer (MVE) provides a complete suite of high-performance pneumatic vitreous cutters with best-in-class tissue-removal efficiency, according to B&L. Operating at up to 2500 cpm, the MVE's 20-, 23-, and 25-g probes offer higher cut rates designed to reduce traction for minimized risk of iatrogenic retinal tears and increased patient safety, the company says. Offering optimized duty cycles with an increased port-size area, the MVE system promotes efficient tissue removal.
Carl Awh, MD, of Tennessee Retina in Nashville, began using the MVE technology in August 2007 and performs the majority of his cases with the MVE 25-g system. He says the vastly improved flow compared to other 25-g vitreous cutters is its most valuable feature. "I am also pleased with the stiffer shaft of the cutter," he says, "as well as the size and weight of the pneumatic handpiece, which is virtually indistinguishable from conventional pneumatic vitreous cutters."
Dr. Awh believes that his patients are attaining improved outcomes due to the minimal trauma to the conjunctiva and sclera by the 25-g vitrectomy and because the MVE has somewhat expanded his indications for 25-g vitrectomy. The optimized port size and duty cycle make it much easier to remove organized hemorrhage, thick bands of scar tissue, and even mature lens nucleus fragments, eliminating much of the need for larger-gauge vitreous cutters.
"In addition to these features, the reduction in the time necessary to remove the vitreous is noticeable," says Dr. Awh. "The ability to more safely approach the retina at higher cut rates with a stiffer and lighter cutter also reduces the need for scissors and instrument exchanges."
The stiffer shaft and smaller hand-piece make it easier to work near the anterior retina or even to enter the anterior chamber via the pars plana in selected cases, Dr. Awh says. "The ability to vary flow while maintaining a setting of 2500 cpm adds tremendous control, allowing both high-flow removal of vitreous with minimal vitreous traction and low-flow vitreous dissection close to the retinal surface, simply by varying aspiration levels."
THE NEXT GENERATION
As for the future, Dr. Awh says that there are a number of "bells and whistles" that will probably be available on the next generation of vitrectomy machines, such as cordless footpedals, more sophisticated control of infusion pressure, and a more elegant user interface.
"However, there are no essential features lacking from the MVE, which provides superior performance as a relatively low-cost upgrade to an existing vitrectomy system (the Millennium)," he states. "Of course, I think that continued improvements in vitrectomy technology are both necessary and inevitable, but the lower cost of obtaining and utilizing MVE technology is a real advantage at a time of tighter budgets and greater cost-sensitivity." RP
For more information on the Bausch & Lomb Millennium Vitrectomy Enhancer, please visit www.bauschretina.com.