EURETINA 2026: How double-cutting technology sped up 27-gauge vitrectomy

At the 26th EURETINA Congress in Vienna, Austria, Mitrofanis Pavlidis, MD, PhD, spoke with Ophthalmology Times Europe about the work behind double-cutting technology for 27-gauge vitrectomy. He has carried out this work with DORC since 2011.

Solving the flow problem

Pavlidis began testing 27-gauge, minimally invasive instruments after moving to Cologne in 2011. He said the approach had clear benefits: sclerotomies were closed at the end of the case, and eyes were well pressurised both straight after surgery and the next day. Early instruments, however, gave slow flow and were too flexible. Core vitrectomy took almost 20 minutes.

To improve flow, Pavlidis proposed adding a second cut and redesigning the cutter. He worked with DORC engineers for 3 years to develop the first double-cutting system, the TDC. It reduced core vitrectomy time from 20 minutes to 5. He described the engineering challenge: “we are talking about very small dimensions: under 500 microns, with a double cutting edge within 200 microns.”

New instruments, pumps and a second-generation cutter

The team went on to develop 27-gauge wide-grip forceps, designed to grasp more material in a single move. At the same time, the VTi pump was developed, followed by the EVA NEXUS system. Pavlidis said its linear vacuum and linear aspiration respond in under half a second, giving “something like an electric-car effect on vitrectomy.”

The second-generation double-cutting probe is the TDC VELOCE. Pavlidis and colleagues completed in vitro and in vivo studies of flow in water, artificial vitreous and porcine vitreous, and reported more than 40% faster flow. The results have been published in Retina.

Bringing platforms together

Pavlidis noted that DORC and ZEISS, 2 companies he had worked with separately, have now merged. He has worked with ZEISS on digital microscopy for 10 years. He described the benefits of combining the vitrectomy machine, the cutting system and the ARTEVO 850 microscope, which offers depth of field and resolution. Work on filtering is ongoing, and the machine’s parameters are now projected into the microscope view.

Developing tools with surgeons

Pavlidis credited DORC’s history of developing instruments with surgeons, including Professor Zivojnović, founder Gerrit Vijfvinkel and Claus Eckardt, who created valved trocars and ILM forceps. He summed up the company’s approach: “get into the OR, see what we are talking about, take the ideas, work together with us and create these things.”

More surgeons and centres are now using the instruments, and they are providing real-world data. Pavlidis said the group will present results in a dedicated session at the FLORetina meeting.