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Cesare Mariotti, Francesca Viti, Teresio Avitabile, Mario Toro, Andrea Saitta, Alfonso Giovannini, Antonio Longo, Vittorio De Grande, Santo Stella, Michele Reibaldi; Iatrogenic retinal breaks in 25-gauge air vitrectomy compared with the standard 25-gauge system for macular diseases. Invest. Ophthalmol. Vis. Sci. 2013;54(15):5788. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To compare the incidence rates of iatrogenic retinal breaks in eyes that underwent 25-gauge air vitrectomy and 25-gauge standard vitrectomy for macular diseases.
Retrospective, comparative, interventional study. We compared the incidence of iatrogenic retinal breaks in 197 eyes of 197 consecutive patients undergoing 25-gauge air vitrectomy (air-group) and 238 eyes of 238 consecutive patients undergoing 25-gauge standard vitrectomy (standard-group) for either idiopathic macular holes (MH) or idiopathic epiretinal membranes (ERM). All surgeries were performed by one surgeon at a single hospital. Main outcome measure was the incidence rate of iatrogenic peripheral retinal breaks discovered intraoperatively and postoperatively.
The incidence rate of iatrogenic retinal breaks was significantly higher in the standard-group than in air-group (8% and 2% respectively; P = 0.005). The percentage of intraoperative retinal breaks was 6% in eyes undergoing standard vitrectomy and 2% in eyes undergoing air vitrectomy (P = 0.034). Retinal breaks were identified postoperatively in 5 eyes (2%) in the standard-group and no eyes (0%) in the air-group (P = 0.066). A postoperative rhegmatogenous retinal detachment developed in 2 eyes (1%) in the standard-group, whereas none in the air-group (0%). The incidence rate of retinal breaks in eyes that underwent vitrectomy for MH was higher in eyes that underwent standard vitrectomy compared with eyes treated by air vitrectomy (17% and 3%, respectively, P = 0.010). In ERM cases, the number of iatrogenic retinal breaks was higher in the standard-group than in the air-group (5% and 1%, respectively), with not quite statistically significant difference (P = NS). A statistically significant relation between posterior vitreous detachment induction and presence of retinal breaks was identified in the standard-group.
25-gauge air vitrectomy is associated with a low incidence rates of iatrogenic retinal breaks compared to standard 25-gauge vitrectomy.
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