{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T10:03:41Z","timestamp":1790071421951,"version":"4.0.1"},"reference-count":39,"publisher":"BMJ","issue":"10","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Br J Ophthalmol"],"accepted":{"date-parts":[[2026,2,12]]},"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:p>This review synthesises clinical evidence on hypersonic vitrectomy (HV), examining the gap between its theoretical advantages and observed performance. Originally proposed to reduce vitreoretinal traction and deliver smoother fluidics, HV has achieved successful vitreous removal in human studies, with surgeons reporting favourable qualitative handling. However, comparative trials have yielded mixed results for surgical efficiency versus contemporary pneumatic guillotine vitrectors. Prospective series also describe operational challenges, including intraoperative conversion to guillotine vitrectors in up to 30% of cases, often attributed to inconsistent vitreous liquefaction. Distinct safety considerations have been reported, most notably sclerotomy-site thermal injury and silicone oil emulsification. These findings underscore the difficulty of surpassing a rapidly evolving standard of care. Defining HV\u2019s role in vitreoretinal surgery will require continued device refinements and adequately powered, multicentre comparative studies to determine where HV offers clear, reproducible benefits.<\/jats:p>","DOI":"10.1136\/bjo-2025-328693","type":"journal-article","created":{"date-parts":[[2026,3,2]],"date-time":"2026-03-02T18:25:12Z","timestamp":1772475912000},"page":"1103-1107","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Cutting without a blade: a clinical review of hypersonic vitrectomy"],"prefix":"10.1136","volume":"110","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-4839-5182","authenticated-orcid":false,"given":"Siddharth","family":"Gandhi","sequence":"first","affiliation":[{"name":"Queen\u2019s University School of Medicine, Kingston, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5948-0331","authenticated-orcid":false,"given":"Michael","family":"Balas","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Parnian","family":"Arjmand","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada"},{"name":"Mississauga Retina Institute, Mississauga, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,3,2]]},"reference":[{"key":"2026092202200728000_110.10.1103.1","first-page":"1","article-title":"David Kasner, MD, and the Road to Pars Plana Vitrectomy","volume":"8","author":"Blodi","year":"2016","journal-title":"Ophthalmol Eye Dis"},{"key":"2026092202200728000_110.10.1103.2","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1097\/IAE.0000000000002365","article-title":"First-in-human clinical study to investigate the effectiveness and safety of pars plana vitrectomy surgery using a new hypersonic technology","volume":"40","author":"Stanga","year":"2020","journal-title":"Retina"},{"key":"2026092202200728000_110.10.1103.3","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0173883","article-title":"Ultrastructural and histopathologic findings after pars plana vitrectomy with a new hypersonic vitrector system. 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