AIM: To determine whether the 23-gauge(23G)vitrecomy cutter could replace scissors in conventional 20-gauge(20G)pars plana vitrectomy for treating severe proliferative diabetic retinopathy(PDR).

METHODS:Non-comparative interventional case series. Totally 27 eyes of 27 patients with PDR stageⅥ confirmed by funduscopy and B-ultrasound scan were enrolled. They underwent 20G vitrectomy, in which 23G vitrectomy cutter replaced scissors to remove neuvascular membrane. All 27 eyes received complete panretinal photocoagulation, 17 eyes received no tamponade, 6 eyes were 12% C₃F₈ tamponade, 4 eyes were filled with silicone oil. The follow up time was 3mo. The operation duration time, iatrogenic retinal tear and retinal bleeding need electric coagulation, best corrected visual acuity(BCVA), retinal reattachment were analyzed.

RESULTS: The operative time was 35-120(average 79.19±29.82)min; intraoperative iatrogenic retinal breaks were detected in 2 eyes(7%). At the end of 3mo follow up, BCVA>0.1 were in 9 eyes, from 0.05-0.1 in 10 eyes, <0.05 in 8 eyes. Retinal reattached in 25 eyes(93%), still detached in other 2 eyes with silicone oil.

CONCLUSION: The 23G vitrectomy cutter could replace scissors in conventional 20G pars plana vitrectomy for treating severe PDR.