The small gauge systems are safe and equally effective than the 20-G system for non-complicated vitreous hemorrhage cases with faster recovery and more comfort for the patient. Increased vitreous clogging with small gauge systems does not extrapolate to an increased risk of complications.

Pars plana vitrectomy has become an important tool in the treatment of vitreoretinal diseases, with newer applications being considered. This has necessitated an overall improvement in the surgical expertise and the innovative supportive technology driving the machines. Frequent use has also brought about a variety of complications, especially during the learning curve that every surgeon faces. The vitreous cavity being enclosed by the retina and the crystalline lens leave little margin for error. Precise control over instrumentation is required in order to avoid inadvertent mechanical touching of these tissues. Tissue respect is of utmost importance and in this review we discuss all possible complications and ways to avoid them and manage them if they occur.Expert Rev. Ophthalmol. 2(4), 645-660 (2007) History