Plugs and stiletto: entry incisions for a 20-gauge instrument system.

A specialized stiletto shaped knife (Stiletto) and self-retaining incision plugs (Sclera Plugs) have been made. They are very useful for creating and temporarily occluding entry incisions for 20-gauge instruments suitable for closed eye intraocular surgery such as vitrectomy, lensectomy, removal of retina and vitreous membranes. The choice of material, configuration and dimensions of these new devices enable one to create incisions in the pars plana which do not leak liquid, gas, or tissue at IOP up to 80 mm Hg, when occupied by 20-gauge cylindrical instruments or Sclera Plugs. The plugs free one or both of the surgeon's hands for use outside the eye for indirect ophthalmoscopy, external surgery, and reduce considerably the time and skill formerly required for proper incision management.