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Ermete Giancipoli, Giuseppe D'Amico Ricci, Francesco Boscia; 27-gauge vs 25-gauge vitrectomy for different retinal pathologies. Invest. Ophthalmol. Vis. Sci. 2017;58(8):5005.
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© ARVO (1962-2015); The Authors (2016-present)
Microincision vitrectomy surgery has obvious advantages over 20 gauge (20-G) vitrectomy. Some debate still exists if changing from 25-G to 27-G probes may add extra benefits to the procedure rather than burdens.In this retrospective study we compared 27-G with 25-G pars plana vitrectomy (PPV) for different retinal pathologies, in terms of surgery duration, best corrected visual acuity (BCVA), intraoperative and postoperative complications
Twenty eyes of 20 patients (6 male, 14 female; mean age: 48 years old), who underwent 27G (10 eyes) or 25G (10 eyes) PPV for different retinal pathologies, were evaluated. The mean duration for total vitrectomy and for different surgical steps was calculated through a review of surgical videos. BCVA and intraocular pressure (IOP) at 1, 7 and 30 days after surgery were also recorded. Post surgical inflammation was assessed at 1, 7 and 30 days after surgery using an anterior segment inflammation score (range from 0 = no inflammation to 2,5 = severe inflammation).
The distribution of retinal pathologies was similar between the two groups: retinal detachment (27G: 2 eyes; 25G: 3 eyes), vitreous haemorrhage (27 G: 3 eyes; 25 G: 2 eyes), epiretinal membranes/macular holes (27 G: 5 eyes; 25 G: 5 eyes).No statistically significant difference was found between 27G and 25G group in terms of mean duration (minutes) of total vitrectomy (10.86 ± 9.5 vs 10.39 ± 6.9; P=0.86), core vitrectomy (6.80 ± 6.54 vs 5.94 ± 2.1; P=0.53), shave vitrectomy (9.1 ± 5.1 vs 9 ± 5; P > 0.99), membrane peeling (7.7 ± 3.5 vs 4.3 ± 0.83; P=0.05) and fluid-air exchange (4.9 ± 5.8 vs 2.8 ± 2.7; P=0.21).No intraoperative complications were reported.Post surgical inflammation score didn’t show significant differences between the 27G and 25G group 1 day after surgery (0.4 ± 0.4 vs 0.37 ± 0.48 respectively; P=0.77).Mean IOP was higher in 25G group than in 27G group at 1 day after vitrectomy (P = 0.1), but no longer at 7 (P = 0.2) and 30 days (P = 0,8).BCVA improved in both groups at 1 month, but only in 25G group the improvement was significant (P = 0.03)
Efficacy and safety of 27G system is comparable to 25G system. We didn’t find significant differences in terms of surgery duration, intraoperative and postoperative complications.The difference in final BCVA could be explained by the variability among patients selected.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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