Purpose of review: To update on the recent developments and surgical applications of intraocular endoscopy, and highlight its role in the modern era of microincision vitreoretinal surgery.
Recent findings: Recent progress in our understanding of the unique intraocular illumination properties of endoscopy, specifically the use of reflected (coaxial) versus conventional transmitted (dissociated) light, is redefining its role in vitreoretinal surgery. Indications for endoscope-enabled intraoperative viewing during pars plana vitrectomy include posterior segment disease with significant anterior segment opacity, difficult-to-access retroirideal diseases involving the sclerotomy, pars plana, pars plicata, ciliary sulcus, ciliary body, or peripheral lens, and complex anterior retinal detachments, particularly in diseases in children. The recent introduction of 23-gauge endoscope that works with standard microcannulas increases its utility.
Summary: Endoscopic vitrectomy, particularly with the recent advent of 23-gauge technology, expands our surgical armamentarium, making it a useful complement to conventional viewing systems.