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Abstract
Vitreoretinal surgery has recently undergone remarkable developments. The introduction of micro-incision vitrectomy surgery using 25- and 23-gauge techniques has led to minimally invasive, faster, safer, and more accurate surgeries. Similarly, intraocular illumination and observation systems have advanced from light pipes to chandelier illumination, slit illumination, wide-angle viewing systems, and intraocular endoscopes. Compared to observation via the cornea and optic media, vitreous surgery using an endoscope is extremely useful, as the endoscope is inserted directly into the eye, circumventing the difficulties of corneal clouding and small pupil diameters. Furthermore, there are no blind spots after surgery. We here discuss the advantages of intraocular endoscope use, the current state of endoscopy-guided vitreoretinal surgery, and its future prospects.
Financial & competing interests disclosure
The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.
No writing assistance was utilized in the production of this manuscript.
Key issues
Endoscope-guided surgery enables treatment of patients whose fundus is difficult to observe with traditional observational methods.
Observation is possible at the extreme periphery without ocular pressurization.
High magnification enables the detection of small lesions.
Postoperative complications such as vitreous strangulation can be prevented.
Probes are becoming thinner as ever smaller micro-incisions are used for vitrectomy.
Improvement of resolution is still necessary for small-gauge endoscopic probes.
Owing to the fact that stereo viewing and observation are not possible on a monitor, some training is required; however, an experienced vitrectomy surgeon should have no issues adopting the technique.
When combined with the wide-angle viewing system, an ideal operation devoid of blind spots is possible.