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BACKGROUND AND OBJECTIVE:To investigate the short-term complication profile of the transconjunctival 20-gauge trocar-cannula (20g-TCV) system.PATIENTS AND METHODS:Patients who underwent primary 20g-TCV without history of prior vitrectomy were included. The primary outcome was incidence of short-term hypotony. Other data collected included visual acuity (VA), rate of sclerotomy suture placement, and intraoperative and postoperative complications.RESULTS:One hundred twenty-seven eyes of 120 patients were included. Postoperative complications included hypotony in 10.2% of eyes at the first postoperative day and 4.7% at week 1, all with spontaneous resolution. No cases of endophthalmitis were observed. Overall mean VA significantly improved from 20/375 preoperatively to 20/221 at month 3.CONCLUSION:Although the rate of short-term hypotony was relatively high, it was transient. This 20g-TCV system does not appear to be associated with other intraoperative or postoperative complications. The authors recommend a low threshold for sclerotomy suture placement if adopting this system.