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相比25G系统，23G更具优势。它结合了20G和25G的优点：经结膜直接穿刺，切口无需缝合；快速建立及关闭切口，节省手术时间；术后恢复快，炎症反应轻，患者舒适度高；器械硬度更高，管径更大，流率提高，照明更亮，眼内操作类似20G，因此病例适应证更广。
第二代23G微创玻璃体切除系统为Alcon生产。相比Dorc系统，进行了大量改进。Alcon微套管系统包括穿刺刀，套管，巩膜塞。其套管“一步”进入眼内。套有套管的穿刺刀平行于角巩膜缘，与巩膜成20°～30°角，穿过结膜巩膜及睫状体；当达到套管与穿刺刀接口时，穿刺刀改变方向旋后刺向后极部；缓慢拔出穿刺刀。Alcon穿刺系统“一步法”之所以能比Dorc“二步法”简便，主要与其器械特点有关：穿刺刀坚硬锐利，刀尖斜面设计，能减少穿刺阻力，刀尖长9.6mm，套管长4mm；套管为钛制，能减少器械与导管之间的摩擦，增加操作的精确性；套管毂长1.5mm，设计了定位夹持槽，术中易于插拨器械，术后易于取下套管；套管能锁定在穿刺刀上，穿刺时不易滑脱。Alcon23G与Dorc23G系统使用的套管管径一致，但是前者的灌注管能移至任意套管，手术时操作更灵活方便。Alcon23G穿刺操作时应注意以下要点：①固定结膜很重要，利用对抗压力避免眼球旋转；②确保套管平行于角巩膜缘，倾斜进入，才能保证切口自动愈合；③插管的过程中力度和速率要均匀。Alcon23G玻切头为2 500cpm高速玻切。切割头重量轻，气动系统，管径比Dorc大，切割头的口径距头的距离比Dorc小，硬度增加，流量增加，与20G相似。
23G经结膜无缝合玻璃体切除手术系统弥补了25G系统的缺点，集合了20G和25G系统的优点，切割率更高，器械更硬，照明更亮，适应证更广，为微创玻璃体切除手术的新选择。
25G和23G经结膜无缝合玻璃体切除手术因其创伤小，手术时间短，术后恢复快，相信在不久的将来会得到更广泛得应用，带来玻璃体视网膜手术的一次革新。
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