25-, 23-, or 20-gauge instrumentation for vitreous surgery?
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.
Williams
G A
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Beaumont Eye Institute, Oakland University, Royal Oak, Michigan, MI 48073-6710, USA. gwilliams@beaumont.edu
D009877:Endophthalmitis / Q000209:etiology; D004867:Equipment Design; D006801:Humans; D014821:Vitrectomy / Q000009:adverse effects / Q000295:instrumentation* / Q000639:trends; D014822:Vitreous Body / Q000601:surgery*