What’s a small gauge vitrectomy?

A vitrectomy is a procedure to remove part or all of the vitreous humour – the jelly-like substance inside your eye – and surgeons have been performing them since the ’60s. Traditionally, they’re done through sclerotomies (otherwise known as key holes) which measure 1.15mm across. Considering you’re likely to need three of these key holes, a procedure like this can really take its toll on your eyes.

Fortunately, at London Medical, we’ve developed a method which reduces the size of keyholes to between 0.75 and 0.4mm. Not only does this sound less unpleasant, there are a world of medical advantages too. For instance, a patient undergoing this type of vitrectomy can expect to have a faster recovery time, may not need surgical stitches, is less likely to experience inflammation inside the eye, and won’t suffer from such severe redness after their operation.

On top of that, the instrument used to perform the operation (officially the vitrector; we call them ‘cutters’) has its tip much closer to the probe – which basically means that the procedure can be performed more safely. Finally, because the wounds are far smaller, the actual procedure takes less time overall.

So, what’s the problem?

Well, when I started using small gauge instruments in 2003, it was clear that they were slightly disappointing, particularly in relation to the disposable instruments. They didn’t have the same level of stiffness and quality – which is incredibly important – and in some instances, the type of scissors used weren’t quite curved enough to get underneath some of the membranes. Since then, and after a lot of development, I’m glad to say that disposables are of excellent quality. But, the trouble is that the cost of disposables is quite high; one single-use forceps or scissor can cost anything between £70 and £130, and there are several other disposables used during one surgery.

So, yes: unfortunately the instruments for a small gauge vitrectomy can be quite costly. But the advantages of this surgery over the traditional alternative more than make up for it. There are a lot of smaller details that I’ve not mentioned in this article as well – so if you’d like to know any more, feel free to get in touch.

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