ASCRS 2025: Advancing vitreous care with Inder Paul Singh, MD

Inder Paul Singh, MD, glaucoma and anterior segment surgeon from southeastern Wisconsin, presented early data on a novel one-step limited vitrectomy device designed for the removal of symptomatic vitreous opacities (CSVO) in pseudophakic patients. “I just got done giving a paper presentation on our first 40-plus patients' experience with a one-step limited vitreous removal device by MST,” Singh said at the 2025 American Society of Cataract and Refractive Surgery annual meeting, held April 25 to 28 in Los Angeles, California.

This new device, which utilizes a 27-gauge needle vitrector with the cutter housed in the needle tip, allows anterior segment surgeons to access the anterior vitreous without the need for trocars. Entering 3.5 mm posterior to the limbus with low vacuum settings, surgeons can remove substantial vitreous opacities that impair vision but do not require a full posterior vitrectomy.

“These are patients who are suffering, unhappy—some of them are about to get a lens exchange. Let's take out the vitreous first before we do a lens exchange,” Singh advised. Objective data using iTrace showed measurable improvements: “We were able to find significant portion of patients who achieved it higher HOA, or improvement in HOA,” he said. Additionally, patients showed improvement in MTF curves, indicating better contrast sensitivity.

Safety outcomes were favorable, with one minor complication—“1 patient who didn’t have a retinal tear, but that was in the first 10 patients where we had high vacuum.” Since adjusting technique to use lower vacuum, no further retinal events occurred.

“The key was high patient satisfaction,” Singh emphasized, noting “over 90% satisfaction patients with almost a 90% decrease in the vitreous opacities around the central of the visual axis.”

This device may offer anterior segment surgeons a promising option for patients with debilitating floaters and poor visual quality post-cataract surgery.