The Open Ophthalmology Journal

ISSN: 1874-3641 ― Volume 14, 2020

Intraoperative Switch to a Temporal Surgical Approach in 23- and 25-Gauge Microcannula-Based Sutureless Transconjunctival Vitrectomy

Szilárd Kiss1, 2, Demetrios Vavvas*, 2
1 Retina Service, Weill Cornell Medical College, Department of Ophthalmology, 1305 York Ave, 11th Floor, New York, New York 10021, USA
2 Retina Service, Massachusetts Eye and Ear Infirmary, Harvard Medical School Department of Ophthalmology, 243 Charles St., Boston, Massachusetts 02114, USA



To illustrate a surgical method in which the infusion port during a three-port pars plana vitrectomy is moved intraoperatively from the traditional infra-temporal location and placed supra-nasally, thus permitting a temporal surgical approach to better tackle superior and inferior vitreoretinal pathology.


Description of surgical technique.


When the location of the vitreoretinal pathology and/or the patient's anatomy prevents adequate visualization or surgical access and/or the instrument flexibility precludes sufficient maneuvering of the eyeball, a temporal approach to the vitrectomy may be employed by utilizing the interchangeable microcannulas of 23- and 25-gauge vitrectomy systems. The infusion port is dis-inserted from the traditional infra-temporal microcannula and reaffixed in the supra-nasal microcannula. The surgeon, the operating microscope, and the foot pedals are then adjusted to a temporal orientation, and the instruments inserted through the temporally placed microcannulas.


The flexibility of interchangeable microcannulas in 23- and 25-gauge PPV systems permits intraoperative switching between superior and temporal surgical sites to better manage posterior segment pathology.

Keywords: Vitrectomy, intraoperative switch, vitreoretinal, transconjunctival, microcannula.

Article Information

Identifiers and Pagination:

Year: 2010
Volume: 4
First Page: 12
Last Page: 14
Publisher Id: TOOPHTJ-4-12
DOI: 10.2174/1874364101004010012

Article History:

Received Date: 14/1/2010
Revision Received Date: 22/1/2010
Acceptance Date: 25/3/2010
Electronic publication date: 31/5/2010
Collection year: 2010

© Kiss and Vavvas; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (, which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Retina Service, Massachusetts Eye and Ear Infirmary, Harvard Medical School Department of Ophthalmology, 243 Charles St., Boston, Massachusetts 02114, USA; Tel: (617) 573-6874; Fax: (617) 573-3678; E-mail:

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