At the 2025 American Society of Cataract and Refractive Surgery (ASCRS) Annual Meeting in Los Angeles, Dr. Brandon D. Ayres, from Wills Eye Hospital and Ophthalmic Partners of Pennsylvania, shared key findings about the 27-gauge, 22,000-cuts-per-minute vitrectomy probe used in pars plana anterior vitrectomy. His presentation highlighted the device’s clinical advantages, its impact on surgical efficiency, and its benefits for patient recovery.
Advantages of the 27-Gauge Vitrectomy Probe
Dr. Ayres explained that most anterior segment surgeons traditionally rely on 23-gauge vitrectomy instruments with lower cut rates. These tools often require the use of a trocar to access the pars plana, a technique that many surgeons are not comfortable with, particularly when it comes to suture closure after the trocar is removed.
In contrast, the 27-gauge, Vista 1-Step vitrectomy probe—used in Dr. Ayres’ study—does not require a trocar and allows for smaller, less invasive incisions. The probe’s high cut rate makes it easier to remove vitreous, while the sharp needle tip eliminates the need for a trocar altogether.
Impact on Surgical Efficiency and Recovery Times
Dr. Ayres noted that surgeons rated the probe’s vitreous cutting efficiency better than conventional devices in 81% of cases. Smaller incisions, which do not require suture closure, lead to quicker healing times and less post-operative discomfort. These benefits help reduce recovery times for patients, improving their overall surgical experience.
Specific Case Scenarios and Benefits
Dr. Ayres has used the 27-gauge vitrector in cases involving vitreous prolapse, such as traumatic cataracts, and in IOL exchanges with an open capsule. In these situations, the device’s efficiency has improved the speed and accuracy of the surgery. However, he mentioned that using the device more than once through the same incision could be challenging due to the small size of the incision.
Improved Safety During Surgery
Regarding intraoperative safety, Dr. Ayres shared that the small gauge of the probe allowed for watertight closure of the incision, without the need for sutures. The high cut rate led to efficient vitreous removal with minimal retinal traction, reducing the risk of retinal tears, hemorrhages, or detachment. No retinal complications were observed in the study, further improving patient safety.
Learning Curve and Handling Experience
Dr. Ayres noted that the learning curve for using the 27-gauge vitrector is minimal. Surgeons reported that inserting the probe into the sclera was “easy” to “very easy” in 59% of cases. The key to successful insertion is controlling intraocular pressure (IOP) and ensuring the needle is perpendicular to the sclera. After just a few cases, surgeons are able to confidently use the 1-Step 27-gauge vitrector.
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