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N. R. Berlon, D. G. Miller, M. A. Novak, S. D. Pendergast, J. M. Coney; Safety and Efficacy of 25-Gauge Vitrectomy Surgery by Experienced Vitreoretinal Surgeons. Invest. Ophthalmol. Vis. Sci. 2009;50(13):5202.
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© ARVO (1962-2015); The Authors (2016-present)
To determine the safety and efficacy of 25-gauge sutureless vitrectomy performed in a single practice by surgeons with at least 1 year’s experience in 25-gauge techniques.
A retrospective consecutive case study was performed analyzing the records of 837 patients who underwent 25-gauge vitrectomy performed in a single specialty practice by surgeons with at least 1 year’s experience in 25-gauge surgery from 2006-2008. All patient charts were pulled and examined by trained technicians who recorded diagnosis, procedure, number of sclerotomy sutures used, intraoperative complications, postoperative complications within 6 months, success of surgery, and whether reoperation was necessary. The results were then compiled and analyzed.
Thirty-two of 782 (4.1%) patients experienced intraoperative complications, with the most common being retinal tears (17, 2.2%), retinal hemorrhage (9, 1.2%), and retinal detachment (4, 0.51%). Four of these 32 patients required reoperation, with one experiencing a postoperative retinal detachment. Thirty-four of 761 (4.5%) patients experienced postoperative complications within 6 months, with the most common being retinal detachment (12, 1.5%), self-limiting hypotony (7, 0.92%), and endophthalmitis (3, 0.38%). Other complications included choroidal effusions (2, 0.26%), decentered IOL (1, 0.13%), ERM (2, 0.26%), glaucoma (2, 0.26%), hyphema (2, 0.26%), macular hole (2, 0.26%), and uveitis (2, 0.26%). Seventeen of the 34 patients required reoperation. All 837 patients were then categorized by diagnosis and the data analyzed for individual success rates, which were as follows: 107 of 109 macular holes (98.2%), 84 of 100 retinal detachments (84.0%), 337 of 338 ERMs (99.7%), and 300 of 312 diabetic cases (96.2%). Finally, the number of sutures used in each case was tallied, with 93.6% of listed cases being truly sutureless, 2.6% requiring 1 suture, 1.6% requiring 2 sutures, and 2.2% requiring 3 sutures.
This review of 25-gauge vitrectomy by experienced surgeons compares favorably with previously documented complication and efficacy rates of 20-gauge vitrectomy surgery.
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