Novelties in vitreoretinal surgery

Posterior segment surgery of the eye has benefited from significant progresses since the perfecting of the first endo-ocular vitrectomy machines (1971). Two names to keep in mind: Robert Machemer and Jean-Marie Parel, inventors of the VISC (vitreous infusion suction cutter). Initially it was of great interest of perfecting the treatment of both complicated retinal detachments with fibrous vitreo-proliferation which obstructed retinal reattachment and diabetic vitreal haemorrhages. There have been many improvements in:-surgical microscopy, optical corneal systems or distant optical systems allowing to work in fluids or gases ;-three port technique allowing introduction of membrane forceps, microscissors, endo-illumination optic-fibers and laser-coagulation fibers through the pars plana.-miniaturization of the cutheads of vitrectomy with independent and assisted suction, cutting and infusion.The gauge reduction of these endo-ocular instruments (20 then 23 and 25 gauge) has allowed no stitch vitreoretinal surgery.Innovation has also consisted in the use of new highly density substances, epiretinal membranes surgery and per-operative membrane staining for a more precise dissection.