Temporal surgical approach in microincisional transconjunctival vitrectomy: different orientation improves access to superior pathologies

Abstract

Microincisional vitrectomy, performed with 23-, 25-, or 27-gauge instrumentation, offers many advantages when compared with conventional 20-gauge vitrectomy. Among the advantages is the possibility of creating small, self-sealing transconjunctival wounds that lead to less postoperative inflammation and patient discomfort and more rapid recovery of visual acuity compared with sutured 20-gauge wounds.1-7 In conventional surgery, the infusion cannula is placed in the inferotemporal quadrant, and 2 sclerotomies are performed in the upper quadrants. In microincisional surgeries, however, interchangeable microcannulas are used, so it is easier to change the position of the infusion cannula to one of the other accesses to the vitreous cavity. This allows the surgeon to perform vitrectomy with a temporal orientation— an approach that can be used regardless of whether it was planned prior to surgery.