During my fellowship training and years in private practice, I have used forceps with a variety of tip styles, handles, and gauges (23, 25, and 27 gauge) from several manufacturers. The disposable Extended Reach Wide Grip 27G Forceps (Dutch Ophthalmic) have become a primary tool in my surgical armamentarium for numerous routine and more complex retinal operations. These forceps have an excellent combination of design, versatility, and cost-effectiveness, and they are now my preferred choice of forceps in cases that require 25- and 27-gauge instrumentation.
At A Glance
- Design, versatility, and cost-effectiveness are all important factors to consider when selecting instruments for microincisional vitrectomy surgery.
- The author’s preferred 27-gauge extended-reach wide-grip forceps are excellent tools for macular peels, peripheral membrane stripping, and manipulation of IOLs, even in highly myopic eyes.
These disposable forceps feature 60% increased gripping width, 260% improvement in gripping area, and 40% enhanced stiffness over standard 27-gauge forceps. Excellent tissue visualization is present during macular peels (which is particularly important with pinch-and-peel techniques), and I have noticed less tissue shearing when peeling delicate internal limiting membranes with these forceps. This latter quality is afforded by the tip, which features a wide and long platform with microserrations (Figure). The instrument’s rigidity allows what I describe as a more 25-gauge feel, lessening aberrant motions that can be noted when using other flexible 27-gauge instruments.
Figure. This image of the Extended Reach Wide Grip 27G Forceps demonstrate the tool’s microserrations. Photo credit: Dutch Ophthalmic.
I use these forceps when peeling dense fibrotic tissue, which commonly presents in patients with proliferative vitreoretinopathy and diabetic tractional retinal detachments. The extended reach also provides access to the posterior pole in patients with highly myopic eyes and enables the safe peeling of the internal limiting membrane. The forceps function well in cases requiring one-piece IOL retrieval and three-piece IOL rescue (such as in the modified Yamane technique).
The forceps are reasonably priced. In the evolving climate of decreasing health care reimbursement and increasing overhead from regulatory oversight, limiting the cost of instrumentation is especially important. This tool is one to consider.