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(Investigative Ophthalmology and Visual Science. 2008;49:1629-1632.)
© 2008 by The Association for Research in Vision and Ophthalmology, Inc.
DOI:  10.1167/iovs.07-1220
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Threshold Amplitude and Frequency for Ocular Tissue Release from a Vibrating Instrument: An Experimental Study

Kristel Maaijwee,1 Twan Koolen,2 Dagmar Rosenbrand,2 Elmer Jacobs,2 Sander Kleinheerenbrink,2 Arjan Knulst,2 Joop Bos,3 Wim P. Holland,3 Alex Brouwer,3 Jan C. van Meurs,1,4 and Sander Schutte2

1From the Department of Vitreoretinal Surgery, the Rotterdam Eye Hospital, Rotterdam, The Netherlands; the 2Department of BioMechanical Engineering, Delft University of Technology, Delft, The Netherlands; the 3Department of Experimental Medical Instrumentation, Erasmus University Medical Center, Rotterdam, The Netherlands; and the 4Erasmus Medical Center, Rotterdam, The Netherlands.

PURPOSE. During retinal pigment epithelium (RPE) and choroid graft translocation in the treatment of patients with exudative age-related macular degeneration, the adhesion of the graft to the translocation instrument complicated its submacular release. Vibration of the instrument improved the release of the graft. This study was conducted to validate the effectiveness of the principle of vibration and to determine the threshold amplitude and frequency required for development of an optimized instrument.

METHODS. An experimental in vitro model with fresh porcine RPE-choroid grafts was used. Release of the graft was studied by a masked observer for amplitudes in the range of 0.05 to 1.2 mm and frequencies in the range of 25 to 200 Hz in the horizontal plane.

RESULTS. The minimum threshold amplitude required to release the graft was approximately 0.15 mm from a frequency of 100 Hz and higher.

CONCLUSIONS. This study confirmed the clinical experience that vibration of an instrument induces the release of the RPE-choroid graft. The minimum threshold amplitude and frequency needed for optimum tissue release were estimated.






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