Smaller-gauge surgery enables greater precision and offers advantages in decreased surgical time, less tissue manipulation, reduced inflammation, postoperative pain, and more rapid visual recovery. While smaller instruments create smaller incisions that violate the eye less, it can be more difficult to fit the instruments required to accomplish tasks through the port. For many surgeons, 23-gauge techniques and instruments offer an ideal compromise between the cumbersome, suture-requiring 20-gauge procedures and the smaller, but more limited, 25- and 27-gauge surgeries.
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