By Ulrich Spandau, Mitrofanis Pavlidis

This publication offers step by step directions on how one can function with 27G instrumentation in a variety of surgical symptoms, together with vitreous floaters, macular holes, dropped nucleus, retinal detachment, diabetic retinopathy, submacular hemorrhage, retinopathy of prematurity and lots more and plenty trauma. All surgical procedures are approached in cookbook style, with preliminary insurance of the “ingredients” (devices and tools) after which meticulous description of practise and function with aiding photos, drawings and movies. additionally, the diversities and merits compared to 23G and 25G vitrectomy are highlighted.

Small-gauge vitrectomy has substantially replaced the ways that vitrectomy is played. 27G vitrectomy is the latest and most fun improvement in small-gauge vitrectomy. The therapeutic time is quicker however the small diameter prolongs the period of surgical procedure. This predicament has been conquer with robust new vitrectomy machines and progressive vitreous cutters with slicing blades making 27G vitrectomy as quick as 25G. This new gear has improved the indicators for 27G surgical procedures immensely from detachment surgical procedure to retinopathy of prematurity and the arrival of latest tools may perhaps make 27G the most desirable sooner or later. This publication, written via authors with large adventure in 27G vitrectomy, will permit surgeons to completely take advantage of its advantages.

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It aspirates in fluid by capillary force and pressure difference. 6 Miscellaneous Fig. 41 A 10 ml silicone oil syringe which is filled with silicone oil. DORC Fig. 42 A 27G cannula is attached to the syringe for silicone oil injection. VFI04 Fig. 43 Silicone oil removal with plastic pipe for 20G–27G (DORC) Fig. 44 Vicryl 8-0 suture for suturing of conjunctiva and sclerotomies 37 38 2 Optimal Visualization, Optimal Instruments and Optimal Technique Fig. 45 Mersilene 5-0 (Ethicon): suturing of a cerclage Fig.

But the actual cutting rate with two cutting blades is 8000 × 2 = 16,000 cuts/min, which reaches new dimensions. The second novelty is continuous and even flow due to the two open cutting ports. This novel technology reduces vitreous traction, decreases the surgical time and increases the safety of surgery (Figs. 9). 75× higher performance than a regular cutter. This results in a fast core vitrectomy. First blade (old) Second blade (new) Second opening (new) First opening (old) Fig. 8 Illustration of a TDC cutter in action.

31 27G disposable curved intravitreal scissors. Indication: cutting of PVR or diabetic membranes. PD04 be removed with the microforceps. Beaver-Visitec, 27G retrobulbar cannula Atkinson. 2 Removal of Membranes Eckhardt Endgripping Forceps (Figs. 29) The 27G endgripping forceps from DORC is a mix of ILM forceps and endgripping forceps. It functions well for ILM, membranes or grasping of luxated IOL. 27PIN 34 2 Optimal Visualization, Optimal Instruments and Optimal Technique a b c Fig. 32 (a–c) A 27G Charles flute instrument (backflush instrument).

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