title: 25-, 23-, or 20-gauge instrumentation for vitreous surgery?
abstract: OBJECTIVE
  To discuss the evolution and current status of 25-, 23-, and 20-gauge vitrectomy instrumentation.
  
  
  METHODS
  Literature review.
  
  
  RESULTS
  There are multiple small case series describing the surgical techniques, clinical outcomes, and complications associated with 25- and 23-gauge vitrectomy. These studies suggest that small-gauge vitrectomy may shorten operating time, improve patient comfort, and speed visual recovery. However, increased complication rates involving hypotony and endophthalmitis have been reported. There are no level 1 evidence-based studies comparing the efficacy and safety of 25-, 23-, and 20-gauge vitrectomy.
  
  
  CONCLUSIONS
  25- and 23-gauge vitrectomy techniques may shorten operating time, improve patient comfort, and speed visual recovery. However, larger and better designed evidence-based studies are required to better understand relative values of 25-, 23-, and 20-gauge vitrectomy.
authors.affiliation: Beaumont Eye Institute, Oakland University, Royal Oak, Michigan, MI 48073-6710, USA. gwilliams@beaumont.edu
authors.forename: G A
authors.initials: GA
authors.lastname: Williams
mesh_terms: D009877:Endophthalmitis / Q000209:etiology; D004867:Equipment Design; D006801:Humans; D014821:Vitrectomy / Q000009:adverse effects / Q000295:instrumentation* / Q000639:trends; D014822:Vitreous Body / Q000601:surgery*