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Vitrectomy with 27-gauge instruments possible, optimal

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ATLANTA — The use of 27-gauge instruments in vitrectomy surgery is both possible and optimal for self-sealing wounds, a surgeon said here.

Yusuke Oshima

"Transconjunctival non-vitrectomizing vitreous surgery and minimal vitrectomy surgery are now feasible with a 27-gauge system," Yusuke Oshima, MD, said during Retina Subspecialty Day preceding the American Academy of Ophthalmology annual meeting. "This system is by far the least invasive for vitreous surgery."

He presented data on 28 eyes of 28 patients who underwent 27-gauge surgery and showed that anatomic success was achieved in all eyes, with 20 eyes (71%) having visual improvement exceeding 0.3 logMAR units. No eyes required conversion to larger instrumentation.

Dr. Oshima showed the many instruments - one-step chandelier, one-step endoilluminator, various forceps, a vitreous cutter, membrane spatula and laser probe - that have been developed for this system.

The 27-gauge cutter, for example, had a cutting port area of 0.079 mm², compared with 0.066 mm² for 25-gauge instruments, while the external diameters were 0.409 mm and 0.515 mm, respectively.