New research on MicroSurgical Technologies Inc’s (MST) Vista 1-Step novel vitrectomy probe evaluated its safety and efficacy performance for removing symptomatic vitreous opacities in pseudophakic patients.
Clinical findings are being presented during the 2025 American Society of Cataract and Refractive Surgery (ASCRS) annual meeting this weekend.
Let’s start with a rundown on the Vista 1-Step.
Commercially available on the U.S. market since last fall, the Vista 1-Step is designed as a 27-gauge, 14.5 mm needle-point vitrector with air supply tubing.
Its purpose: To perform one anterior or posterior vitrectomy procedure by removing vitreous and dissecting tissue in the eye via:
- Vitreous aspiration and cutting
- Membrane cutting aspiration
- Lens removal
And what’s the intent for this device?
With a dual blade cutter delivering up to 1,000 cuts per minute, the intent is for the vitrectomy probe to provide a seamless pathway through the sclera.
Importantly: This can be done without the need for microvitreoretinal (MVR) blades or trocars.
Got it. Now talk about this new research.
Important to note: This prospective clinical trial was approved by an Institutional Review Board (IRB), which is responsible for reviewing and monitoring human subject-involved biomedical research.
- Also keep in mind: An IRB has the authority to approve, request modifications for, or reject research.
Moving on to the study ...
Investigators performed a limited vitreous removal procedure using the Vista 1-Step on 56 pseudophakic patients (78 eyes).
How this worked: The Vista’s 27-gauge needle was attached to a Stellaris phacoemulsification machine and used 5,000 cuts per minute to enter 3.5 mm behind the limbus.
Then: Once surgeons could no longer see vitreous opacities coming to the tip of the needle, it was removed.
A couple of notes about this procedure:
- High vacuum was initially used (for the first 10 eyes) before switching to low vacuum < 100).
- No trocars were utilized—thanks to the use of the Vista 1-Step—while an anterior chamber (AC) maintainer was used to maintain the eye’s stability.
And after?
Following the procedure, post-operative measurements were performed:
- Immediately postop
- Postop week 1 (POW1)
- Postop month 1 (POM1)
- Postop month 3 (POM3) iTrace
- This device measures and analyzes wavefront aberrations, corneal topography, pupillometry, keratometry, and autorefraction
- Intraocular pressure (IOP)
- Dilated fundus examination (DFE)
- Subjective assessments
Now to the findings.
At POM3, all 78 eyes presented with symptomatic improvement—with 86% reporting “complete resolution of symptoms,” according to the clinical abstract.
- As for the remaining 14%: Those patients reported an 85% average improvement.
How did vitreous opacities compare preop versus postop?
On average, improvement was 3.2 (from 3.6 down to 0.4).
Plus: Higher-order aberration (HOA) improved from 2.6 to 0.8—an improvement of 1.8.
And visual acuity?
By POWI, visual acuity (VA) returned to baseline numbers for 100% of patients.
On average: VA improved by 0.6 lines postop.
Any IOP spikes?
Just two out of the 56 eyes developed an IOP spike of > 10 mmHg from baseline.
However, that spike was resolved by POM1.
And any retinal tear developments?
One eye did develop a retinal tear; that was treated without sequelae.
Per the study’s abstract: “This eye … underwent surgery with high vacuum.”
So what did investigators conclude?
Based on this data, the study authors reasoned: “Limited vitreous removal with the 1-Sstep 27 gauge needle vitrector appears to be a safe and effective treatment option for patients suffering from symptomatic vitreous opacities.”
Sounds promising! Where can I get the full details on this study?
If you’re attending ASCRS in Los Angeles, California, this weekend (April 25-28), you’re in luck!
Inder P. Singh, MD, will be presenting the full study rundown on Sunday (April 27) at 8:30 am - 8:35 am PDT (see here for location information).
The presentation title: Safety and Efficacy Outcomes of a Novel Vitrectomy Device Used to Remove Symptomatic Vitreous Opacities in Pseudophakic Patients.