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Sweta Tarigopula, Anju G. Aggarwal, Prashant Thomas, Uday Desai, Paul Edwards, Hua Gao; Comparison Of Iatrogenic Peripheral Retinal Tears Between Small (23- Or 25-) Gauge And 20-gauge Vitrectomies. Invest. Ophthalmol. Vis. Sci. 2011;52(14):6123.
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Iatrogenic peripheral retinal tears related to sclerotomy during vitrectomy are the most common iatrogenic retinal tears reported previously. The purpose of this study was to compare the incidence of these retinal tears in small (23- or 25-) gauge to 20-gauge pars plana vitrectomy.
This is a retrospective comparative study comprising 394 eyes from 368 consecutive patients who underwent pars plana vitrectomy. 243 eyes underwent 23- or 25-gauge pars plana vitrectomy and 151 eyes underwent 20-gauge vitrectomy. The main outcome measure was the presence of iatrogenic retinal tears around sclerotomy found intraoperatively.
In 151 eyes with 20-gauge vitrectomies, iatrogenic retinal tears related to sclerotomy were found in 11 eyes. In 243 eyes with small gauge (23- or 25-gauge) vitrectomies, this type of iatrogenic retinal tears were only found in 2 eyes. There is a much lower incidence of iatrogenic retinal tears related to sclerotomy in small gauge vitrectomy compared to 20-gauge vitrectomy (p<0.05).
Small gauge vitrectomy appears safer in terms of iatrogenic retinal tears around sclerotomy than 20-gauge vitrectomy. It is likely that trocars used in small gauge vitrectomy prevent potential tractions on the vitreous base from instruments when they are inserted into or withdrawn from eyes. This is probably why small gauge vitrectomy causes much less iatrogenic retinal tears than 20-gauge vitrectomy without trocar protection.
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