NOV 05, 2007
By Nancy M Holekamp, MD
Retina/Vitreous
An editorial by Hilel Lewis, MD, in the American Journal of Ophthalmology, is likely to be controversial. He presents a logical, substantiated yet stinging attack on sutureless microincision vitrectomy surgery – a technique that has gained rapid adoption in the vitreoretinal community.
Dr. Lewis writes: “It is my opinion that sutureless microincision vitrectomy surgery is trendy, costly, and has minimal and not very important theoretical benefits. Furthermore, there is no evidence that it is associated with better outcome than is more conventional vitrectomy, and in fact it may be riskier.”
Dr. Lewis calls for emerging vitrectomy technology to be validated by surgical outcome factors such as better final vision, fewer complications, and fewer reoperations. This exposes an interesting double standard within our practice of medicine: While new drugs must generally be shown to be safe and effective prior to their introduction to clinical practice and marketing to physicians, “minor modifications” of existing surgical techniques have not been held to this standard.
Emerging surgical technology will carry the day – sutureless microincision vitrectomy surgery is here to stay.