Non-stick surface for surgical instruments may reduce risk for vitreoretinal detachment

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FORT LAUDERDALE, Fla. — A non-stick surface for instruments and cannulas inspired by nature may help reduce the risk for vitreoretinal detachment, according to a speaker at the Retina World Congress.

Tarek Hassan, MD, said being able to limit iatrogenic complications of vitrectomy — such as retinal tears and detachments resulting from vitreoretinal traction — would be a significant evolution in vitreoretinal surgery. He said the rate of retinal tears in straightforward indications ranges from 1.5% to 16%, while retinal detachment ranges from 1% to 2.5%.

Tarek Hassan, MD

Image: Alex Young | Healio

“That is not that infrequent,” he said. “It’s probably too much for these cases.”

Hassan explained that it is common to see vitreoretinal traction occur from the vitreous sticking to the cannulas and instruments inside the eye during vitreoretinal surgery.

To find a way to make repellant surfaces on these instruments, Hassan and colleagues looked to nature, where hydrophobic and lipid-repellant surfaces are common. These surfaces have a microscopic roughness that creates air pockets in grooves that allow liquid or other substances to glide over them.

Hassan said etching patterns that mimic these surfaces onto surgical instruments using a femtosecond laser creates repellant surfaces without the need for coatings. Hassan and colleagues tested instruments by applying water and egg whites to mimic aqueous humor and vitreous. While the substance stuck to stainless-steel instruments, it slid right off the etched ones. They later tested the instruments with actual human aqueous humor and vitreous with the same results.

Hassan said these instruments have an indication in many vitreoretinal procedures, including vitrectomy, subretinal drug delivery and intraocular trauma. He is currently trying to engineer the instruments for mass production in a way that is cost-effective. However, the implications are clear, he said.

“We can eliminate the most common cause of iatrogenic retinal breaks — sticky vitreous — with something like this,” he said.

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