We have to perform our surgical techniques with utmost efficacy, widest safety margin, and least cost.

Some instruments can be fashioned oneself in a way that achieves all targets of 23 gauge vitrectomy:

1. Intravitreal triamcinolone acetonide cannula

2. Heavy liquid (PFC) cannula

3. 23 gauge needle pick

4. Silicone oil cannula

5. Non-bent 23 gauge needle for ILM flap creation.

By being able to fashion some simple instruments one can t least be prepared for any unanticipated absence- whether by damage or desterilization of any of these instruments. Thus one can always have a feasible alternative available.