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D. Ozone, Y. Hirano, J. Ueda, T. Yasukawa, M. Yoshida, Y. Ogura; Surgical Results of 25 Gauge Vitrectomy for Proliferative Diabetic Retinopathy. Invest. Ophthalmol. Vis. Sci. 2010;51(13):1748.
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© ARVO (1962-2015); The Authors (2016-present)
To investigate the feasibility and efficacy of vitrectomy surgery with 25 gauge system for proliferative diabetic retinopathy (PDR)
One hundred-sixty-five eyes of 138 patients were enrolled in this study. All patients underwent primary vitrectomy in Nagoya City University Hospital, and were followed up for more than 1 month after surgery from September 2005 through July 2009. Primary and ultimate anatomic success, intraoperative and postoperative complications, and final visual success were evaluated.
This series included 68 eyes (41%) with simple vitreous hemorrhage, 69 eyes (42%) with proliferative membrane, and 36 eyes (22%) with tractional retinal detachment due to proliferative membrane. The mean age was 57 years (range 26-79). The mean follow up time was 9 months (range 1-43). The mean logarithm of the minimum angle of resolution (logMAR) visual acuity (VA) significantly improved from 1.39±0.93 to 0.61±0.81 (P<0.0001). The VA improved by 0.3 or more logMAR unit in 116 eyes (71%), stabilized in 43 eyes (25%), and deteriorated in 6 eyes (7%). Sixty-five eyes (39%) obtained the final visual acuity in decimal unit higher than 0.5. Intraoperative iatrogenic retinal breaks were occurred in 19 eyes (11%), intraocular pressure (IOP) elevation higher than 24 mmHg in 43 eyes (26%), and lower than 7 mmHg in 11 eyes (7%). Thirty-six eyes (22%) underwent gas or air tamponade due to intraoperative iatrogenic retinal breaks, and 12 eyes (7%) underwent silicone oil tamponade. Postoperative vitreous hemorrhage occurred in 72 eyes (43%), but only 5 eyes (3%) were required reoperation. Postoperative retinal detachment and neovascular glaucoma occurred in 2 eyes (1%), and 8 eyes (5%), respectively.
Surgical results were comparable with those of 20 gauge vitrectomy. The complications were less and the visual prognosis was excellent.
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