General Advantages and Disadvantages of 20, 23, 25 and 27 Gauge Vitrectomies

Abstract

Over the last half-century, vitreoretinal surgery has evolved from 20-gauge to 23-, 25- and 27-gauge vitrectomy, also known as micro-invasive vitrectomy, with the development of technology and instrumentation. The most important difference of 20-G vitrectomy from other systems is that it creates a larger sclerotomy and therefore requires sutures. Although its large diameter is an advantage depending on the surgical indication, the necessity of sutures also brings disadvantages. On the other hand, micro-invasive vitrectomy systems usually do not require sutures due to their smaller diameter, and suture-related complications are not encountered. Other important advantages are that they can also be used in complex vitreoretinal surgeries. Although they have lower infusion and aspiration rates compared to 20-G vitrectomy as a result of their small diameter, each system has advantages and disadvantages depending on the surgical indication used. This review aims to comparatively present the general advantages and disadvantages of the 20-, 23-, 25- and 27-gauge vitrectomies.