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New Instrument
October 1, 2005

Pulsed Electron Avalanche Knife (PEAK-fc) for Dissection of Retinal Tissue

Author Affiliations

Author Affiliations: Department of Ophthalmology, Ludwig-Maximilians-University, Munich, Germany (Drs Priglinger, Haritoglou, Alge, Gandorfer, and Kampik); Department of Ophthalmology and Hansen Experimental Physics Laboratory, Stanford University, Palo Alto, Calif (Dr Palanker).

Arch Ophthalmol. 2005;123(10):1412-1418. doi:10.1001/archopht.123.10.1412

Objective  To evaluate the effectiveness and precision of tractionless retinal tissue dissection by the advanced version of the pulsed electron avalanche knife for fine cutting (PEAK-fc; Carl Zeiss Meditec, Jena, Germany).

Methods  Porcine retina (in vivo) and human retina (in vitro) were incised with the PEAK-fc using various pulse parameters. The globes were then processed for light microscopy. Evaluation of all specimens focused on depth of the retinal cuts and on the degree of collateral damage.

Results  Retinal cuts performed both in vivo on porcine eyes and on human donor eyes showed very sharp edges with only little collateral damage. With probes of 600 μm in length, the optimal pulse parameters for precise and reproducible cutting of the retina were an amplitude of 350 to 380 V, a repetition rate of 300 Hz, and 30 “minipulses” per pulse of 100-microsecond duration. With increasing voltage, cuts also affected the retinal pigment epithelium and the choroid, followed by intravitreal bleeding during in vivo application.

Conclusion  We demonstrated that PEAK-fc is capable of precisely cutting retinal tissue in vivo and in vitro using optimal pulse parameters. Further in vivo studies will be necessary to determine the efficacy of this new tractionless cutting device in vitreoretinal surgery.