J Korean Ophthalmol Soc.  2013 Aug;54(8):1236-1240.

Comparison of 20, 23 and 25 Gauge Vitreoretinal Surgical Instruments

• Kim DW
• Cho SW
• Lee TG
• Kim CG
• Kim JW
• Lee JH
• Han JI

Abstract

PURPOSE
To investigate the diameter, the infusion and aspiration rate of 20-, 23- and 25-gauge vitreous cutters, and compare the theoretical and practical intraocular pressure (IOP) change according to the height of the bottle.
METHODS
A vitreous cutter was disassembled to measure the actual external and internal diameter. The infusion rate was measured at the height of 40, 60, 80, 100 and 120 cm and the suction rate was measured at a pressure of 100, 200, 300, 400 and 500 mm Hg for each gauge. IOP during the operation was calculated according to the bottle height and the actual IOP was measured using a mercury sphygmomanometer.
RESULTS
The external diameter of the 20-, 23- and 25-gauge was 900, 596, and 500 mm, respectively, and the internal diameter was 670, 450, and 380 mm, respectively. The infusion rate increased in direct proportion to the bottle height. The aspiration rate increased as the pressure increased. However, the increment of the infusion and aspiration rate in the 20-gauge vitreous cutter was the highest and decreased in the 23- and 25-gauge, in that order. IOP was calculated as 29, 44, 59 and 74 mm Hg when the bottle height was at 40, 60, 80 and 100 cm, respectively, and was measured 34, 50, 62 and 74 mm Hg, respectively.
CONCLUSIONS
The infusion and aspiration rates per outer diameter in the 23- and 25-gauge vitreous cutters and infusions using cannula were lower than in the 20-gauge vitreous cutter. The difference of the infusion and aspiration rates per diameter between the 23- and 25-gauge vitreous cutters and infusions was not significant.

Keyword

Vitreoretinal instrument; Vitreous cutters

MeSH Terms

Catheters
Intraocular Pressure
Suction
Surgical Instruments

Figure

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  Figure 1. (A) Photographs of 20-, 23-, 25-gauge vitre-ous cutters. (B) Enlarged photograph of outer and inner tube of 23-gauge vitreous cutter (a: external diameter of outer tube, b: external diameter of inner tube, c: hori-zontal diameter of cutter opening, d: vertical diameter of cutter opening, e: thickness of outer tube).

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  Figure 2. The measurement of infusion pressure. (A) Balanced salt solution and line are directly connected to mer-cury sphygmomanometer. (B) Three way catheter is connected with balanced salt solution and line, infusion line and mercury sphygmomanometer.

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  Figure 3. Balanced salt solution infusion rate according to the bottle height using the 20-gauge, 23-gauge, 25-gauge infusion cannula.

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  Figure 4. Balanced salt solution aspiration rate according to the aspiration vacuum using the 20-gauge, the 23-gauge and the 25-gauge vitreous cutter.

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  Figure 5. Intraocular pressure change according to the bottle height calculated by nomogram.

Reference

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