Different preferences between United States and European vitreoretinal surgeons: personal observations

This article describes the author's personal observations on different preferences in surgical technique and surgical setting between vitreoretinal specialists in the USA and Europe. These impressions, although clearly subjective, derive from the author's extensive experience with, and connection to, many vitreoretinal centers and surgeons around the world in a wide variety of venues.

Although the results of surgery and the availability of information and instrumentation are quite comparable on both sides, vitreoretinal surgeons in the USA are more likely to use local anesthesia, an outpatient setting, perform phakic vitrectomy, use gas as opposed to oil as a tamponade, use pneumatic retinopexy for certain cases, place an anterior chamber lens for secondary implantation, and perform intravitreal injections in the office or exam room. In addition, European colleagues more commonly perform combined phacoemulsification with intraocular lens implantation at the time of vitrectomy, use perfluorochemicals during retinal detachment surgery, and utilize heavy silicone oils.

These observations suggest that many factors, both medical and nonmedical, influence vitreoretinal surgeons and result in differing preferences for surgical techniques and surgical setting.