Purpose:
To compare 20-gauge plana vitrectomy (20GPPV), 23-, and 25-gauge microincision vitrectomy surgery (23G- and 25G-MIVS) for repair of primary macular hole retinal detachment.
Methods:
Fourtyeight eyes of 47 patients who underwent primary macular hole retinal detachment repair with 20GPPV, 23G-, or 25G-MIVS were included from March 1, 2006 to 31 April 2011. The medical records were retrospectively reviewed and the corresponding demographic information, preoperative conditions, surgical management, and postoperative course and treatment were recorded.The mean follow up period was 321 days.
Results:
Preoperative characteristics were similar between the three procedures.All eyes underwent primary vitrectomy using either 20GPPV, 23G-, or 25G-MIVS instruments, internal limiting membrane peeling and gas or silicone oil tamponade. Single operation success rate was 12/16(75%) for 20GPPV, 10/13 (77%) for 23G-MIVS and 14/19 (74%) for 25G-MIVS (P =0.97).The closure rate of the macular hole rate was 11/16(69%) for 20GPPV, 10/13 (77%) for 23G-MIVS and 9/17 (53%) for 25G-MIVS (P =0.37).100% of patients achieved final reattachment after multiple surgeries except for the three patients who dropped out in follow up periods
Conclusions:
Outcomes of 20GPPV versus 23G-, or 25G-MIVS for the management of macular hole retinal detachment were not significantly different as compared with the 20-gauge group.Therefore, MIVS may be considered a primary treatment for macular hole retinal detachment.
Keywords: macular holes • retinal detachment • macula/fovea