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Updated: May 29, 2026
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Implantation Protocol of the Foldable Capsular Vitreous Body for Complex Vitreoretinal Surgery
Published on: April 14, 2026
Difficulty in inserting 25- and 23-gauge trocar cannula during vitrectomy.
Hiroshi Kunikata1, Fumihiko Nitta, Yasuhiko Meguro
1Department of Ophthalmology and Visual Science, Tohoku University Graduate School of Medicine, Sendai, Japan. kunikata@oph.med.tohoku.ac.jp
Summary
Difficulty inserting trocar cannula (DITC) during micro-incision vitrectomy surgery (MIVS) occurred in 0.6% of cases. Risk factors for DITC include large retinal detachment, choroidal detachment, high myopia, and hypotony.
Area of Science:
- Ophthalmology
- Surgical Innovation
- Retinal Surgery
Background:
- Micro-incision vitrectomy surgery (MIVS) utilizes small gauge trocar cannulas for vitreous access.
- Difficulty in trocar cannula insertion (DITC) can complicate MIVS procedures.
- Understanding risk factors for DITC is crucial for surgical planning and patient safety.
Purpose of the Study:
- To determine the incidence of difficulty in inserting 25- and 23-gauge trocar cannulas (DITC) during 25- or 23-gauge micro-incision vitrectomy surgery (MIVS).
Main Methods:
- Retrospective, consecutive, interventional case series.
- Single surgeon, single center study.
- Analysis of 1,525 eyes undergoing MIVS, defining DITC as inability to insert at least one trocar cannula.
Main Results:
- The overall incidence of DITC was 0.6% (9 of 1,525 eyes).
- Eyes with retinal detachment (RD) had a higher DITC incidence of 3.3% (8 of 242 RD eyes).
- Significant risk factors identified for DITC in RD eyes included large RD, choroidal detachment, high myopia, and hypotony.
Conclusions:
- Large retinal detachment, choroidal detachment, high myopia, and hypotony are significant risk factors for DITC during MIVS.
- Cautious MIVS performance is recommended for eyes presenting with these risk factors.
