In Chap. 6, I stated that the VR surgeon is only as good as his nurse. This is almost1 equally true regarding the armamentarium at the surgeon’s disposal.

An entire book could be written about the equipment used by today’s2 VR surgeon. Only a selected few items are discussed here and even those to only a certain extent.

12.1The Vitrectomy Machine and Its Components3

The key factor determining the quality of the machine is how precisely the surgeon can control what happens inside the eye as a consequence of his maneuvers, i.e., how little traction the probe exerts on the retina during vitreous removal.

12.1.1 The Pump

12.1.1.1 Peristaltic Pump: Flow Control

This is the pump used in the original, early machines; it now lives its renaissance because it allows precisely controlled removal of material from the vitreous cavity,

1“Almost” is the key word. A dedicated and experienced surgeon can be successful even when some of the tools he otherwise considers necessary are unavailable or their quality is suboptimal.

2When I started VR surgery, the probe was “multifunctional”: a single handpiece that cut/aspirated and provided infusion and light. The cut rate was very low, unavoidably exerting traction on the retina – especially because the cutter was rotating, not guillotine. The light pipe slid over the cutter, and the vitreous was often caught between them, with disastrous consequences; finally, the light was very weak. Surgery was monomanual (through a single sclerotomy, which was almost 3 mm long). There were no scissors, forceps, intraocular gas, silicone oil, endodiathermy, endolaser, air pump (A-F-X!), and PFCL (I treated the giant tear by lying on the floor and injecting air into the eye of the patient who was turned facedown on the operating table) – and this is an incomplete list.

3The characteristics are individually analyzed here, but the surgeon has to understand that many of these features are interconnected.

F. Kuhn, Vitreoretinal Surgery: Strategies and Tactics,

DOI 10.1007/978-3-319-19479-0_12