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Classically, surgery for dropped lens fragments is managed with 20-gauge (G) pars plana vitrectomy (PPV) or with a hybrid 20/23-G PPV. To our knowledge there are no reports using only 23G PPV instruments (Crushing technique).


23G vitrector has a higher flow rate and a longer duty cycle than any 20G vitrector. So it is expected to be capable of removing efficiently lens fragments, without the need of opening an additional 20G port for the phacofragmatome, as we demonstrate in this case series.


42 eyes of 42 patients with retained lens fragments underwent 23G PPV using ‘Crushing technique’ over a 5-year period.

Effectiveness / Safety:

At the last examination, mean (± SD) best corrected visual acuity was 0.43 (± 0.35). The most common complications observed were ocular hypertension in 14 patients (9.5%), two cases of cystoid macular edema (4.8%) and one case of retinal detachment (2.3%). Crushing technique demonstrated to be safe and efficient even for hard and whole nuclei. The outcomes were comparable to those found in the literature for 20G surgery.