High-frequency electric welding: a novel method for improved immediate chorioretinal adhesion in vitreoretinal surgery.

purposeTo evaluate high-frequency electric welding (HFEW) as a novel technique for retinopexy with improved immediate chorioretinal adhesion

methodsIn a prospective, randomized, experimental study, we examined 104 eyes of 52 rabbits randomly assigned to either standard 810 nm endolaser retinopexy, alternating current 14-16 V or 18-20 V HFEW retinopexy. A full-thickness fragment of eye wall tissue containing the retinopexy was isolated 1 h, 3 days, 1 week, or 1 month respectively after the intervention, and fixed to an analytical electronic scale. A nylon suture passed through the retina was elevated by a biomechanical force elongation tester. The reduction in weight at the time of retinopexy rupture was registered as a measure for retinopexy adhesion strength.

resultsOne hour post-exposure, adhesive strengths were significantly higher in both HFEW groups than in controls (212 ± 26.6 mg and 122 ± 16 mg vs 104 ± 10 mg; p = 0.0001 and p = 0.024 respectively) while laser retinopexy did not significantly change adhesive strength (114 ± 14.0 mg, p = 0.149). Subsequent adhesive strengths were significantly increased for all retinopexy techniques: 3 days post-op 14-16 V HFEW 224 ± 30.0 mg (p = 0.001), 18-20 V HFEW 128 ± 15.6 (p = 0.001), laser 131 ± 12.7 mg (p = 0.0007); at 1 week 14-16 HFEW 235 ± 24.7 mg, 18-20 V HFEW 213 ± 22.4 mg, laser 188 ± 18.7 mg (all p ≤ 0.001); 1 month post-op 14-16 V HFEW 275 ± 32.0 mg, 18-20 V HFEW 283 ± 31.0 mg, laser 276 ± 21.7 mg, rspectively (all p ≤  0.0001).

conclusionHFEW represents a novel technique for retinopexy during vitreoretinal surgery. It allows firm chorioretinal adhesion immediately after exposure. In non-vitrectomized eyes, using 14-16 V is particularly effective.