Transition to a novel advanced integrated vitrectomy platform: comparison of the surgical impact of moving from the Accurus vitrectomy platform to the Constellation Vision System for microincisional vitrectomy surgery

ansition to a novel advanced integrated vitrectomy platform: comparison of the surgical impact of moving from the Accurus vitrectomy platform to the Constellation Vision System for microincisional vitrectomy surgery Original Research (510) Total Article Views Authors: Murray TG, Layton AJ, Tong KB, Gittelman M, Latiff A, Gologorsky D, Vigoda MM Published Date February 2013 Volume 2013:7 Pages 367 - 377 DOI: http://dx.doi.org/10.2147/OPTH.S35603 Received: 04 July 2012 Accepted: 14 October 2012 Published: 19 February 2013 Timothy G Murray,1,2 Andrew J Layton,3 Kuo B Tong,3 Michael Gittelman,2 Azeema Latiff,1,2 Daniel Gologorsky,2 Michael M Vigoda2 1Murray Ocular Oncology and Retina, Miami, FL, USA; 2Bascom Palmer Eye Institute, Anne Bates Leach Eye Hospital, Departments of Ophthalmology, Anesthesiology and Radiation Oncology, University of Miami Miller School of Medicine, Miami, FL, USA; 3Quorum Consulting, San Francisco, CA, USA Background: Microincisional vitrectomy surgery (MIVS) is the current standard surgical approach for pars plana vitrectomy. Historically, the most common surgical platform for vitrectomy surgery, since its introduction in 1997, has been the Accurus vitrectomy system. Recent introduction of the next generation of vitrectomy platforms has generated concerns associated with transitioning to new technology in the operating room environment. This study compared, in a matched fashion, surgical use of the Accurus vitrectomy system and the next generation Constellation Vision System to evaluate surgical efficiencies, complications, and user perceptions of this transition. Methods: Electronic health records were abstracted as a hospital quality assurance activity and included all vitreoretinal surgical procedures at the Bascom Palmer Eye Institute, Anne Bates Leach Eye Hospital, during two discrete 12-month time periods. These two periods reflected dedicated usage of the Accurus (June 2008–May 2009) and Constellation Vision (July 2009–June 2010) systems. Data were limited to a single surgeon and evaluated for operating room (OR) total time usage/day, OR case time/case, and OR surgical time/case. Further analysis evaluated all patients undergoing combined MIVS and clear cornea phacoemulsification/intraocular lens (IOL) implantation during each individual time period to determine the impact of the instrumentation on these parameters. All records were evaluated for intraoperative complications. Results: Five hundred and fourteen eligible patients underwent MIVS during the 2-year study windows, with 281 patients undergoing surgery with the Accurus system and 233 patients undergoing surgery with the Constellation system. Combined MIVS and phacoemulsification with IOL implantation was performed 141 times during this period with the Accurus and 158 times during the second study period with the Constellation. Total number of patients operated per day increased from 7.55 with Accurus to 8.53 with Constellation. Surgical room time decreased f