Vitreo-retinal surgery had incredible advancements over the last decades. Development of new vitrectomy machines, endoillumination and viewing systems and obviously the microincision vitrectomy surgery (MIVS), made this kind of procedures faster and safer.
Essential for MIVS, trocars were developed allowing an easy and atraumatic transconjuntival entry to the posterior segment. In the recent years several improvements in this type of accessories were observed, which have improved its introduction in the eyeball, endurance, ability to create auto-sealing ports and more recently valved trocar, with a better control of the intraocular pressure and eye outflow during the surgery.

In this paper we present other applications for MIVS trocars, which in our opinion, may facilitate some complex ophthalmic surgeries. In all cases we used non-valved25 or 23 gauge trocars from Alcon (EDGEPLUS®, Alcon, USA).
A first indication is its use in surgeries for drainage of extensive suprachoroidal hemorrhages. The surgery is performed after ultrasound confirmation of liquefaction of the choroidal hematoma. After placement of an intraocular infusion channel, often through the anterior chamber, a 23G trocar is introduced into the quadrant more affected with choroidal hemorrhage , according to ultrasound exam. This trocar is inserted gently, with an angle of 20-30 degrees, parallel to the limbus, and after entering the cutting tip, only the cannula progresses, avoiding iatrogenic retinal damage. After removing the trocar blade, the cannula is repositioned in the suprachoroidal space in other to have the better drainage of the hematoma. Other openings may be undertaken to obtain the best possible drainage of the blood. No sutures of those ports are necessary. The surgery continues with the subsequent MIVS.
Another use found for these MIVS accessories is in complex anterior segment surgeries with pupilloplasty, in which the trocar is placed in the limbic area and through the cannula we can introduced and removed the pupilloplasty sutures, ensuring through a small incision ( 23 or 25 gauge) a free and easy passage of suture material. At the end, the trocar is removed and often no suture of the limbic entrance is necessary.