Early approaches to vitreous surgery
The first recorded vitreous surgery was performed in 1863 by Albrecht von Graefe, who used a needle to penetrate the vitreous membrane.
By the 1960s, various experimental techniques had emerged, but most were unsuccessful in achieving long-term results.
In the 1960s, Kasner introduced the "open-sky technique," involving a large limbal incision, corneal removal, and lens extraction to access the vitreous. However, this approach was fraught with complications, including corneal opacities and retinal detachment B2.
Robert Machemer: The pioneer of modern vitrectomy
In the early 1970s, German-born ophthalmologist Robert Machemer developed the Vitreous Infusion Suction Cutter (VISC). This revolutionary device enabled the safe removal of vitreous humour via the pars plana, reducing intraoperative pressure fluctuations and laying the foundation for modern pars plana vitrectomy B3.
Rudolf Klöti: Innovator in surgical refinement
Around the same time, Swiss ophthalmologist Rudolf Klöti advanced vitrectomy technology by focusing on miniaturising instruments and refining surgical techniques. Together with Heinz Oertli, the founder of Oertli Instrumente AG, Klöti developed the “Vitreous Stripper,” a revolutionary vitrectomy cutter that integrated aspiration, cutting, and infusion into a single instrument. This device became the gold standard in vitreous surgery, enabling safer and more precise procedures.
Heinz Oertli, who established his workshop in St. Gallen in 1955, brought decades of experience in crafting ophthalmic instruments. His early innovations, including tools for strabismus and corneal surgeries, laid the groundwork for the collaboration with Klöti. Together, they not only designed the Vitreous Stripper but also pioneered advancements such as diathermy instruments, peristaltic pumps, and light-guiding systems. These tools significantly enhanced surgical precision and efficiency, setting new standards for vitreoretinal procedures B4 B5.
Dual linear pedal
Initially, only a linear pedal was available, allowing control over just one parameter at a time. In 1985, Oertli Instrumente AG introduced the dual-linear pedal, enabling independent control of two parameters, e.g., pump system and vitrectomy cutting rate.
Trocar system
Since its introduction in 2008, Oertli’s trocar system has continued to evolve. The current Caliburn Trocar System combines a sharp, lance-shaped blade, bevelled cannula design, tactile markings and an integrated 4-flap self-sealing membrane to support smooth trocar placement.
Klöti and Oertli’s combined efforts marked a turning point in the field, demonstrating the power of interdisciplinary collaboration between surgeons and instrument makers. Their work laid the foundation for modern micro-incision vitrectomy surgery (MIVS), highlighting how innovation and partnership can transform patient care.
