2.3 Vitrectomy Settings

Constellation Settings

  • I always use 35-45 mmHg unless child or low blood pressure (general anaesthesia, over-sedation, some dialysis patients – check retinal venous pulsation intraoperatively)
  • Using 15-20 mmHg infusion results in even lower IOP because of fluidic resistance in the infusion line during fluid flow

Cutting Rate

  • Always use highest cutting rate for all tasks including core vitrectomy
  • A lower cutting rate can be used for dense scar tissue, lens capsule or lens material only after all vitreous has been removed, although one can try removing these tissues using maximum vacuum first

Aspiration

  • I always use proportional (linear) aspiration, not 3D or dual linear
  • High cutting rates reduce pulsatile vitreoretinal traction

Pump Type

  • I always use venturi rather than peristaltic pump to enable better control when near the retina. This also enables vitrectomy under air

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Westmead Eye Manual
This invaluable open-source textbook for eye care professionals summarises the steps ophthalmologists need to perform when examining a patient.

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