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25-Gauge Transconjunctival Sutureless Pars Plana Vitrectomy for the Removal of Retained Lens Fragments and Intraocular Foreign Bodies

25-Gauge Transconjunctival Sutureless Pars Plana Vitrectomy for the Removal of Retained Lens Fragments and Intraocular Foreign Bodies Surgical innovation in modern vitrectomy technique has resulted in less invasive and less traumatic procedures for the treatment of posterior segment disorders. In 1972, Machemer et al1 introduced the 17gauge vitreous cutter that required a 2.3-mm scleral incision for pars plana vitrectomy (PPV). In 1975, O’Malley and Heintz2 produced a smaller 20-gauge vitrector for use in a three-port sclerotomy system that has become the standard for modern day PPV. In 1990, de Juan and Hickingbotham3 developed the 25-gauge vitrector, membrane dissector, and microforceps with a diameter of 0.5 mm. By 2002, this system evolved into the current microcannula-based 25-gauge transconjunctival sutureless vitrectomy technique.4 With significant advancement in techniques and refinements in surgical instrumentation, a trend of more frequent use and expanding indications for 25-gauge PPV has developed.5–15 Compared with the traditional 20-gauge techniques, 25-gauge vitrectomy permits the use of smaller, self-sealing wounds that may allow patients to recover quicker and may avoid the discomfort associated with conjunctival and scleral sutures. Additionally, intraoperative time, postoperative inflammation, patient discomfort as well as recovery time may be lessened.14 There is also the added advantage of using interchangeable ports. Importantly, with less tissue manipulation and diminished surgical trauma, the diminished conjunctival scarring may also result in a higher success rate for future glaucoma surgical procedures, such as trabeculectomy. The purpose of the present study was to evaluate the practicability, anatomic and visual outcomes, and to describe a technique of lens fragment and intraocular foreign body (IOFB) removal using transconjunctival 25-gauge PPV.