Combined 25- and 23-gauge surgery: a new sutureless vitrectomy technique

The 25- and 23-gauge sutureless vitrectomy techniques decrease the surgical trauma and improve patients' postoperative comfort. The disadvantages of the 25-gauge system include pliable instrument and slower gel removal. The 23-gauge system provides faster speed of vitrectomy and the instruments have stiffer shafts, but it requires a larger incision. To circumvent some of these limitations, a new sutureless transconjunctival vitrectomy technique that combines 23- and 25-gauge cannulas and instruments was studied. Fifty-three patients underwent vitreoretinal surgery using two 25-gauge ports for the infusion and light probe and one 23-gauge port for the vitreous cutter and various instruments. No intraoperative or postoperative complications were noted and no cases required conversion to another technique.