Jorge A. Fortun, MD, Assistant Professor of Clinical Ophthalmology and Medical Director at Bascom Palmer Eye Institute in Palm Beach Gardens, Florida, shares his surgical impressions of the Dutch Ophthalmic EVA™ Phaco-Vitrectomy surgical platform. Dr. Fortun said, “all platforms work great; however, the EVA works best in my operating room.” Over the years, he has completed many surgical platform comparisons since he is known for his innovative surgical techniques and depth of knowledge about instrumentation.
During Dr. Fortun’s recent RetinaLink interview, he provides additional insight on EVA’s (TDC) Two-Dimensional Cutter, VacuFlow Valve Timing Intelligence and overall, platform performance. His surgical video highlights EVA’s 27-gauge platform and utilizing the Two-Dimensional Cutter in a patient with a Tractional Retinal Detachment.
RetinaLink (RL): How long have you been using Dutch Ophthalmic’s EVA™ Phaco-Vitrectomy System?
Jorge A. Fortun, MD (JAF): I’ve been using the EVA platform for close to two years.
RL: Please explain EVA’s Vacuflow Valve Timing Intelligence (VTi).
JAF: VTi represents a novel platform that is in essence a functional hybrid between traditional venture pump and peristaltic systems allowing for more direct surgeon control of flow.
RL: Flow control on surgical platforms has been debated at retina meetings for years. Please outline EVA’s flow mode and how it responds during your surgical cases.
JAF: The flow mode allows me to increase or limit my flow through direct input at the console level. In traditional venturi pump based machines, the surgeon only has direct control of vacuum. Secondarily, flow is controlled indirectly via “port based” flow which is dependent on factors such as cut rate and cutter gauge. EVA is novel because I can easily set a precise flow rate in cc/min giving me a real sense of control over how vitreous and tissues move at the cutter opening. This flow control translates into increased safety when maneuvering at the retinal surface as in cases of RRD and when dissecting membranes in cases of PVR or diabetic TRD.
RL: What is your preferred small gauge platform?
JAF: The majority of my cases are 25-gauge. I often will use 27-gauge for macular cases and complex diabetics. Maneuvering with a smaller gauge when working on pre-retinal tissues is optimal. With DORC’s TDC cutter, 27-gauge surgery has become a more viable option as there is not as big a drop off in flow and consequently efficiency of vitreous removal with smaller gauges.
RL: What impresses you most about EVA’s Two-Dimensional Cutter?
JAF: Due to cutting of vitreous in both directions of the cutter stroke, EVA’s TDC cutter operates at an effective rate of 16,000 cuts per minute (cpm). Faster cut rates translate into increased safety by reducing traction on vitreous strands and the retina. Also, because of the TDC cutter’s design, the port remains open 92% of the time which means that even at these safer and higher cut rates, flow rates remain high when efficient vitreous removal is needed.
Dr. Jorge Fortun can be reached via e-mail – JFortun@med.miami.edu
For more information on the Dutch Ophthalmic EVA – http://www.dorc.eu
Photo Credit: Kevin Caldwell Photography – Vit-Buckle Society Annual Meeting – Las Vegas (April 2019)