27-Gauge Vitrectomy for Primary Rhegmatogenous Retinal Detachment: Is it Feasible?

Dear Editor, Pars plana vitrectomy (PPV) using the 27-gauge transconjunctival approach is the last frontier of small gauge vitrectomy. Only 1 paper has been published so far describing the use of 27-gauge vitrectomy in a limited number of cases, including epiretinal membranes, idiopathic macular holes, diabetic vitreous haemorrhages, a vitreous biopsy for presumed vitreoretinal lymphoma and a focal diabetic retinal detachment.1 The use of 27-gauge vitrectomy systems, although innovative and effi cient thanks to the high cut rate and vacuum, has met with some skepticism for the treatment of rhegmatogenous retinal detachments (RRD).2 The main concerns are related to the stiffness of the light and vitrectomy probe, the ability of adequately removing the vitreous gel throughout such small probe, and the time required to perform a full vitrectomy. Furthermore, there is concern for potential postoperative hypotony due to the loss of tamponade, recognised as a major complication in eyes treated for RRD.3 We report our experience using a 27-gauge vitrectomy system for repair of primary RRD.