Performance of a Trocar Sleeve Adapter for Faster Silicone Oil Extraction in Real-World Vitreoretinal Surgery

<b>Objectives</b>: To assess the performance of a high-flow viscous-fluid-extraction cannula as a 23G trocar sleeve adapter (1362.VFE2, DORC, Zuidland, the Netherlands) for removing regular and heavy silicone oil (SO) in real-world vitreoretinal surgery. <b>Methods</b>: In this retrospective study, 90 eyes undergoing SO removal were analyzed. The 23G trocar sleeve adapter was evaluated in 30 eyes for regular SO (DORC Silicone 5000) and 30 eyes for heavy SO (Densiron^® 68). The latter were compared with a standard disposable heavy-SO-extraction cannula (1272.HSE06, DORC) in another 30 eyes. <b>Results</b>: Removal of DORC Silicone 5000 using the trocar sleeve adapter required 332.0 ± 122.8 s. To extract Densiron^® 68, the adapter was significantly faster than the standard heavy-SO cannula (162.6 ± 85.6 s vs. 619.3 ± 128.8 s; <i>p</i> < 0.0001). <b>Conclusions</b>: The 23G trocar sleeve adapter efficiently extracts both regular and heavy SO, reducing the time required to extract Densiron^® 68 by four-fold compared with a dedicated heavy-SO cannula. Its use can markedly shorten surgical time in real-world vitreoretinal procedures.