title: Hybrid 25- and 27-Gauge Vitrectomy for Complex Vitreoretinal Surgery.
abstract: OBJECTIVE
  The authors report the technique of using the 27-gauge (G) vitreous cutter through 25-G valved cannulas to allow hybrid instrumentation of both gauges.
  
  
  METHODS
  Vitrectomy is initiated with standard placement of 25-G valved cannulas, followed by insertion of a 27-G vitreous cutter through the 25-G cannulas.
  
  
  RESULTS
  The hybrid procedure emphasizes the advantages of both platforms: The 25-G cutter is more efficient for core vitrectomy and is more rigid to facilitate peripheral vitrectomy; the 25-G platform enjoys a wider armamentarium of instrumentation options; and the smaller profile of the 27-G cutter can be maneuvered more easily into tight surgical planes to act analogous to vertical scissors, with the added benefits of aspiration and spatula-like features. The authors illustrate this technique in three cases: diabetic tractional retinal detachment with dense plaques, posterior stage 4B retinopathy of prematurity, and sutureless scleral fixation of an intraocular lens.
  
  
  CONCLUSIONS
  Hybrid use of the 25-G and 27-G platforms offers greater versatility for the management of complex vitreoretinal conditions.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Yonekawa
authors.forename: Aristomenis
authors.initials: A
authors.lastname: Thanos
authors.forename: Ashkan M
authors.initials: AM
authors.lastname: Abbey
authors.forename: Benjamin J
authors.initials: BJ
authors.lastname: Thomas
authors.forename: Bozho
authors.initials: B
authors.lastname: Todorich
authors.forename: Lisa J
authors.initials: LJ
authors.lastname: Faia
authors.forename: George A
authors.initials: GA
authors.lastname: Williams
authors.forename: Antonio
authors.initials: A
authors.lastname: Capone
authors.forename: Jeremy D
authors.initials: JD
authors.lastname: Wolfe
authors.forename: Tarek S
authors.initials: TS
authors.lastname: Hassan
mesh_terms: D003930:Diabetic Retinopathy; D058450:Endotamponade; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D017075:Laser Coagulation; D019654:Lens Implantation, Intraocular / Q000379:methods*; D008297:Male; D008866:Microsurgery / Q000379:methods; D008875:Middle Aged; D012163:Retinal Detachment / Q000601:surgery*; D012178:Retinopathy of Prematurity / Q000601:surgery*; D012590:Sclera / Q000601:surgery*; D014821:Vitrectomy / Q000295:instrumentation / Q000379:methods*; D057586:Vitreoretinal Surgery