Since 1972, when Robert Machemer, MD, developed the concept of pars plana vitrectomy,1 there have been many changes to vitreoretinal surgical instrumentation. Traditional vitrectomy involved the use of 20-gauge sclerotomies and required suturing. New, smaller gauges of surgical instruments have permitted less invasive surgery with reduced need for sutures. In this article, we detail our experience with technology from Bausch + Lomb for posterior segment vitrectomy. In 2001, Eugene de Juan, MD, and colleagues, working in collaboration with Bausch + Lomb, developed the Millennium Transconjunctival Sutureless Vitrectomy (TSV25) system, which featured an electronic 25-gauge vitrectomy tip and vitreous cutter speeds up to 1500 cuts per minute (cpm).2 In 2007, the Millennium Vitrectomy Enhancer (MVE) system (Bausch + Lomb) was introduced, incorporating new, more rigid surgical instrumentation with a 23-gauge option and cutting speeds up to 2500 cpm. The newest vitrectomy system from Bausch + Lomb, the Stellaris PC Vision Enhancement system, introduced in 2010, features ultrafast pneumatic cutter speeds up to 5000 cpm, instrumentation control with stiffer tips (23- and 25-gauge), enhanced illumination, and an integrated intraocular pressure (IOP) management system. From 2002 to 2013, we have performed 1329 vitrectomies using these 3 different 25-gauge systems. We used the TSV25 from 2002 to 2006,3 the MVE from 2007 to 2009,4 and the Stellaris PC from 2010 to 2013.
Since 1972, when Robert Machemer, MD, developed the concept of pars plana vitrectomy,1 there have been many changes to vitreoretinal surgical instrumentation. Traditional vitrectomy involved the use of 20-gauge sclerotomies and required suturing. New, smaller gauges of surgical instruments have permitted less invasive surgery with reduced need for sutures. In this article, we detail our experience with technology from Bausch + Lomb for posterior segment vitrectomy. In 2001, Eugene de Juan, MD, and colleagues, working in collaboration with Bausch + Lomb, developed the Millennium Transconjunctival Sutureless Vitrectomy (TSV25) system, which featured an electronic 25-gauge vitrectomy tip and vitreous cutter speeds up to 1500 cuts per minute (cpm).2 In 2007, the Millennium Vitrectomy Enhancer (MVE) system (Bausch + Lomb) was introduced, incorporating new, more rigid surgical instrumentation with a 23-gauge option and cutting speeds up to 2500 cpm. The newest vitrectomy system from Bausch + Lomb, the Stellaris PC Vision Enhancement system, introduced in 2010, features ultrafast pneumatic cutter speeds up to 5000 cpm, instrumentation control with stiffer tips (23- and 25-gauge), enhanced illumination, and an integrated intraocular pressure (IOP) management system. From 2002 to 2013, we have performed 1329 vitrectomies using these 3 different 25-gauge systems. We used the TSV25 from 2002 to 2006,3 the MVE from 2007 to 2009,4 and the Stellaris PC from 2010 to 2013.