Advances in Vitreo-retinal Surgery: 23-gauge Sutureless Pars Plana Vitrectomy

Pars plana vitrectomy is one of the most common surgical procedures performed for the treatment of various vitreo-retinal diseases such as retinal detachment, vitreous haemorrhage, proliferative diabetic retinopathy, epiretinal membrane and macular hole. Traditionally, most vitrectomy surgical systems utilise the 20-gauge instruments pars plana vitrectomy includes multiple incisions including periotomy (opening of the conjunctiva) and sclerotomy. In the past few years, advances in the development of surgical instruments have enabled the performance of vitrectomies using smaller gauge instruments such as 23 and 25-gauge, and thus allowing the performance of sutureless vitrectomies. The 23-gauge sutureless vitrectomy system has the advantages to overcome the excessive flexibility of instruments associated with a 25-gauge pars plana transconjunctival sutureless vitrectomy system which might cause difficulties in manoeuvring the globe during surgery. Most major vitreo-retinal surgical instrument manufacturers have already made a 23-gauge vitrectomy system available. With the increasing availability and better designed instruments, the 23-gauge sutureless system has become one of the preferred vitrectomy systems in the vitreoretinal community in recent years.