| Haddrill, Marilyn, "Eye on Industry: Syntec's VitMan Vitrectomy System
Offers Portability, Economy," Eye World, Vol. 3, No. 9, (September 1998). |
Eye on Industry: Syntec's VitMan Vitrectomy System
Offers Portability, Economy
In many countries outside the United States, necessary vitreoretinal procedures are not
performed because systems supporting such surgeries are too expensive. Now, a new
company--Syntec--has introduced an affordable, portable machine to world markets.
The need for economical vitreoretinal surgery systems in countries outside the United
States inspired Syntec Inc. President Richard J. Gillette and other backers to form a
development company in January 1994.
"We started the company because we observed a strong gap in the technological area
between the U.S. market and the rest of the world." Gillette said. "That gap was
basically because of the high cost of the systems used in retinal surgery. Our goal is to
make vitrectomy surgeries affordable for the rest of the world."
He said surgeons from outside the country who would train in the U.S. as vitreoretinal
surgeons returned to their home countries only to find that they were unable to practice
in their chosen field because of the expense.
Gillette, whose background is in electronic engineering and design, left a large
financial information systems company to assemble an experienced engineering staff to
invent a low-cost alternative to more expensive vitreoretinal systems.
"We didn't copy anything. What we did do was innovate and improve existing
technology." Gillette said. "We made significant improvements in the aspiration
systems. We have patents on that. We also made some improvements in the light source and
we have patents on that, also."
The result was Syntec's VitMan, distinctive because it is portable and sells for less
than $30,000. Gillette said the price is significantly less than other systems, which cost
$40,000 to $80,000.
The vitrectomy system uses a rocking-style piston vacuum pump. Company literature
describes the system as capable of a "high-speed vacuum response that outperforms
even venturi-based systems." Other features include an aspiration cassette and rapid
vacuum level control. Weighing about 45 pounds, the VitMan is about the size of a large
briefcase, and has its own carrying handle.
"It's a software-controlled electronic and mechanical system," Gillette said.
The VitMan can be connected to any electrical line or to air pressure in the operating
room, according to Gholam A. Peyman, MD, an ophthalmology professor and chief of
vitreoretinal surgery and oncology service at the Louisiana State University Medical
Center School of Medicine in New Orleans.
"The frequency of cutting can reach 1,000 cpm. I find the light source to be as
bright as the Grieshaber unit, while providing a means of using three-fiber optics
simultaneously from the same light source," said Peyman, who has been evaluating the
VitMan since early this year.
The light source illuminated three fibers simulultaneously, said Wei He, MD, PhD,
president of Shenyang Silver Sea Eye Center in Shenyang, China.
"This feature makes it possible for bimanual methods using different manipulation
with the light source," he said. "The system records the surgery parameters on a
floppy disk during surgery."
In May, the U.S. Food and Drug Administration approved the system for U.S. markets.
"It's inexpensive enough that surgeons can have it in their offices," Gillette
explained. "And it's portable. It can be carried from one site to another."
The company is emphasizing overseas markets such as China, pointing out that FDA
approval lends credibility to the system worldwide.
"The opportunity is just phenomenal right now," Gillette said.
"We can provide an inexpensive system. In other parts of the world, 90% of the
surgeries that should be done are not being done."
As a private company, Syntec does not release sales or employment figures. The company
has two sites in the St. Louis, MO., area. One facility is for design and manufacturing,
the other is for making disposable parts--such as tips for the light probe--associated
with the system.
Gillette said prototypes have been established in other areas, such as vitreous biopsy
equipment, viscous fluid injection, and stand-alone lighting sources.
"We're proceeding to rapidly develop other products now, all in the vitreoretinal
area."
| Bethke, Walter, "Instruments for a Better Vitrectomy," Review of
Ophthalmology (August 1998) 81. |
Instruments for a Better Vitrectomy
If you are interested in making vitrectomy easier and safer, read on. Manufacturers
have come up with a number of ingenious, high-tech devices designed to make surgery
easier, more efficient and less risky.
Syntec VitMan. If you have to operate in several different places during the
course of a week, and don't like to reacquaint yourself with a different vitrectomy
machine each time, this instrument may help. Syntec says its VitMan vitrectomy unit is
small enough to fit into a large briefcase, yet it still offers several features normally
available only on larger instruments.
The company says the unit's aspiration system has been specially designed to track the
position of the foot pedal as precisely as possible, to minimize or eliminate the lag that
can occur between a surgeon pushing the pedal and the aspiration rate increasing. The
VitMan also has the ability to power three lighted instruments simultaneously. The company
says this allows a surgeon to have a third lighted instrument ready to go when he or she
needs it, rather than having to remove one lighted instrument from the eye, change tips,
then put the new one back in.
Syntec also says that even though the unit is relatively small, it has enough digital
memory to allow 12 surgeons to store up to seven sets of parameters each. The company says
this saves surgeons the time of having to reprogram the machine each time they use it,
since it "remembers" their preferences regarding maximum aspiration levels,
ultra-sound settings, and vitrector cutting speeds.
The VitMan is available for under $30,000, and comes with the light source, vitrector,
ultra-sound and air exchange functions.
| Peyman, Gholam A., Kertes, Peter J., and Easley, James, "A New Light Source
for Vitreous Surgery," Retina, Vol. 17, No. 5 (undated), 466. |
A New Light Source for Vitreous Surgery
GHOLAM A. PEYMAN, MD,*
PETER J. KERTES, MD,*
JAMES EASLEY, BS
| From the *LSU Eye Center, Louisiana State University Medical Center School of
Medicine, New Orleans, Louisiana, and Syntec, Inc., Winfield, Missouri. |
| ___________________ |
Supported in part by the U.S. Public Health Service grant EY02377
from the National Eye Institute, National Institutes of Health, Bethesda, Maryland, and by
an unrestricted departmental grant from Research to Prevent Blindness, New York, New York.
Dr. Peyman and Mr. Easley have a proprietary interest in the
instrument.
Reprint requests: Gholam A. Peyman, M.D., LSU Eye Center, 2020 Gravier
Street, Suite B., New Orleans, LA 70112-2234. |
The introduction of lighted instruments has facilitated complex two-handed maneuvers in
vitreoretinal surgery. Most conventional light sources, however, accommodate only a single
fiberoptic light, and the simultaneous use of more than one lighted instrument requires at
least one other light source. With the popularity and widespread use of new indirect
wide-angle viewing systems,1,2 adequate and precise
illumination have become especially important. We have designed a light source that allows
for the use of up to three fiberoptic instruments at one time (Figure 1). All three
fiberoptics will illuminate at an intensity (35 mW of power in the visible spectrum)
comparable with the currently available Grieshaber light source (32 mW). This is achieved
with a 150-watt tungsten halogen lamp coupled with state-of-the-art optics. Any unused
ports have a shutter mechanism that closes to minimize stray light.
Moreover, should lamp failure occur intraoperatively, the machine's control hardware
senses the failure and automatically moves a backup lamp into position. Such failure may
be anticipated by the system's ability to record and report, on the machine's front
display panel, the number of hours a bulb has operated.
With the growth of endoilluminating instruments and technology has come an awareness
and concern for the effects of phototoxicity.3 To this
end, a white light dimming mechanism is built into the light source. Unlike conventional
dimming strategies that work by either decreasing the light aperture or color temperature,
the dimming of this light source is achieved by interposing an extremely think dimming
disk with a hole against the end of the optical fiber (Figure 2). This makes the fiber
appear to have a smaller diameter and thereby reduce the light output. However, because
the dimming disk does not affect the light impinging on the uncovered portion of the
fiber, the output dims without affecting the output aperture.
Fig. 1 (Left). Photograph of the light source removed from the
vitrector demonstrates how three light pipes with pie-shaped adapters can be accommodated
by the instrument.
Fig. 2 (Right). Schematic diagram illustrating the
mechanism of white-light dimming produced by the described light source. A thin dimming
disk with a hole is placed against the end of an optical fiber. As it is moved, the disk
partially blocks the end of the optical fiber from the focused cone of light coming from
the light source (right). This makes the fiber appear to have a smaller diameter and thus
reduces the light output. Because the light coming from the uncovered portion is
unaffected, the output dims without affecting the output aperture.
| Key words: endoillumination, fiberoptic light, vitreoretinal surgery. |
References
1. Spitznas M. A binocular indirect ophthalmomicroscope (BIOM) for
non-contact wide-angle vitreous surgery. Graefes Arch Clin Exp Ophthalmol 1987; 225:13-15.
2. Bovey EH, Gonvers M. A new device for noncontact wide-angle viewing of
the fundus during vitrectomy. Arch Ophthalmol 1995;113:1572-1573.
3. Azzolini C, Brancato R, Venturi G, et al. Updating on intraoperative
light-induced retinal injury. Int Ophthalmol 1994-1995;18-269-276. |
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