title: Intraoperative switch to a temporal surgical approach in 23- and 25-gauge microcannula-based sutureless transconjunctival vitrectomy.
abstract: OBJECTIVE
  To illustrate a surgical method in which the infusion port during a three-port pars plana vitrectomy is moved intraoperatively from the traditional infra-temporal location and placed supra-nasally, thus permitting a temporal surgical approach to better tackle superior and inferior vitreoretinal pathology.
  
  
  METHODS
  Description of surgical technique.
  
  
  RESULTS
  When the location of the vitreoretinal pathology and/or the patient's anatomy prevents adequate visualization or surgical access and/or the instrument flexibility precludes sufficient maneuvering of the eyeball, a temporal approach to the vitrectomy may be employed by utilizing the interchangeable microcannulas of 23- and 25-gauge vitrectomy systems. The infusion port is dis-inserted from the traditional infra-temporal microcannula and reaffixed in the supra-nasal microcannula. The surgeon, the operating microscope, and the foot pedals are then adjusted to a temporal orientation, and the instruments inserted through the temporally placed microcannulas.
  
  
  CONCLUSIONS
  The flexibility of interchangeable microcannulas in 23- and 25-gauge PPV systems permits intraoperative switching between superior and temporal surgical sites to better manage posterior segment pathology.
authors.affiliation: Retina Service, Weill Cornell Medical College, Department of Ophthalmology, 1305 York Ave, 11th Floor, New York, New York 10021, USA.
authors.forename: Szilárd
authors.initials: S
authors.lastname: Kiss
authors.forename: Demetrios
authors.initials: D
authors.lastname: Vavvas