1. Hello , pls let me know what cut rate , vacuum do you use for anterior vitrectomy in pediatric cataract surgery , I use anterior approach.
    Thank you .
    Dr . Fatma .
    Saudi Arabia

    1. If using a posterior segment vitrectomy such as the Alcon Constellation or Acurus, with a 20 or 23g handpiece, I set the initial cut rate high, around 2500 and have it decrease to 100 when the pedal is fully depressed. This gives a high cut rate for normal vitreous and capsule work with slower cutting to engage dense or scarred capsule or lens nucleus as needed. Inversely, I start with a low vacuum 0 that increases to 300 as the foot pedal is depressed. This allows you to precisely trim a capsulotomy and place the minimum amount of pulling on the vitreous unless you need it. When using anterior segment machines for vitrectomy, it is a bit more complicated and less effective… if not been very happy with them in my limited experience but when I have used anterior segment machines such as the Alcon Laureate, I used a cut rate of 250-1000 (slower for lens, faster for vitreous) with an aspiration flow of 5-10 and vacuum of 100-250 (lower for vitreous and higher for lens). I would be very interested to hear the comments of others who mainly use anterior segment machines… any advice out there?

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