vitrector

A vitrector is a surgical instrument used to remove the vitreous humor from the eye during a pars plana vitrectomy, a retinal surgery. The instrument is connected to an external suction source and includes a small-gauge, hollow cutting tip housed in a handpiece. A cutting port and a rapidly actuated guillotine cutter divide vitreous as it is drawn into the tip, and the cut fragments are aspirated away. An accompanying infusion line maintains intraocular pressure by replacing the removed fluid.

Vitreous removal is achieved by coordinated suction, cutting, and infusion. Modern systems may employ dual or electronic cutting mechanisms, allowing variable cut rates and duty cycles to optimize vitreous removal while minimizing traction on the retina. Illumination for the intraocular working space is provided by an endoilluminator through a separate port. Many vitrectors are designed for multiple gauges, enabling microincisional approaches.

Common gauge options include 23-, 25-, and 27-gauge systems, with larger 20-gauge systems still in use in some settings. Microincisional vitrectomy surgery (MIVS) uses small, sutureless ports that cause less tissue disruption and often allow faster recovery. Some systems integrate infusion, illumination, and cutting functions in a single setup, while others use separate cannulas for infusion and instrumentation.

Vitrectomy with a vitrector is indicated for a range of retinal and vitreous disorders, including rhegmatogenous retinal detachment, vitreous hemorrhage, macular holes, epiretinal membranes, diabetic retinopathy complications, and intraocular infections. Risks include retinal tears or detachment, cataract progression, intraocular pressure fluctuations, cataract formation, and infection.

The development of vitrectors began in the 1970s, significantly advancing retinal surgery through automated, controlled vitreous removal and smaller-gauge instrumentation.