Transconjunctival sutureless 20G

Purpose To evaluate a trocar system that allows the use of the regular 20‐gauge vitrectomy instruments for a transconjunctival sutureless surgery for the treatment of various surgically treated vitreo‐retinal pathologies. Methods The 20‐gauge trocar system uses a 10° self‐sealing tunneled incision made with trocars introduced with a inserter blade of 0.9 mm diameter. Incisions are radially made at 3.5 mm from the limbus and tunnels are made limbus‐parallel. Evaluation of the surgical procedure, sclerotomies closure by OCT, anatomical and visual outcomes in various vitreoretinal pathologies treated in current vitreoretinal practice. Results Postoperative patient comfort and less eye inflammation are provided by the sutureless technique, allthough small conjunctival hemorrhage caused by the grasping forceps used to hold the eye during the insertion of the trocars may occur. The 20‐gauge trocar system using 10° self‐sealing tunneled incision remains very stable in the eye even during peripheral vitrectomy with indentation and they also decrease the surgical induced trauma at the entry sites. The use of nonflexible instruments, the same as in 20‐gauge conventional vitrectomy, provides easy access to the entire periphery.thus the system can be used in almost all vitreoretinal surgeries. It allows the use of phragmatome and is easy to work even with 5,000 centistokes silicone oil. Conclusion In the era of sutureless surgeries, the 20‐gauge trocar system is a safe, comfortable, convinient with current instrumentation and less expensive alternative to 25‐ and 23‐gauge vitrectomy.