A 27-gauge instrument system for transconjunctival sutureless microincision vitrectomy surgery

Area of Science:

• Ophthalmology
• Retinal Surgery
• Microsurgery

Background:

• Microincision vitrectomy surgery (MIVS) utilizes small gauge instruments for vitreoretinal procedures.
• Evaluating novel instrument systems is crucial for advancing surgical techniques and patient outcomes.

Purpose of the Study:

• To assess the efficiency, safety, and feasibility of a 27-gauge transconjunctival MIVS system.
• To evaluate its performance in treating a range of vitreoretinal diseases.

Main Methods:

• An experimental, interventional case series involving 31 eyes across various vitreoretinal conditions.
• A novel 27-gauge instrument system was developed and tested.
• Key metrics included cutter duty cycle, fluid dynamics, intraoperative/postoperative outcomes, and complications.

Main Results:

• The 27-gauge system demonstrated comparable or superior cutter duty cycle to 25-gauge systems.
• 100% anatomic success was achieved, with 65% of eyes showing visual improvement of 3 lines or more.
• All sclerotomies self-sealed effectively, avoiding hypotony and the need for conversion to larger gauges.

Conclusions:

• The 27-gauge MIVS system is a feasible option for selected vitreoretinal surgeries.
• It may mitigate concerns regarding wound-related complications associated with MIVS.
• Further evaluation of its fluid dynamics and cutting efficiency compared to larger gauges is warranted.