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Y. Iordanous, K. J. Warrian, A. Zhou, M. Francispragasm, K. Chow, K. Gill, J. R. Gonder; Safety and Complication Profile of 25-Gauge Vitrectomy for Epiretinal Membrane Peeling, Primary Retinal Detachment and Macular Hole Repair. Invest. Ophthalmol. Vis. Sci. 2010;51(13):1759.
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To evaluate the safety and complications associated with sutureless, transconjunctival 25-gauge vitrectomy for epiretinal membrane removal, as well as macular hole and primary retinal detachment repair.
A retrospective chart review of a single surgeon’s practice was conducted to identify all patients receiving surgery using 25-gauge vitrectomy for epiretinal membrane peeling, as well as retinal detachment and macular hole repair between January 2005 and December 2009. Intraoperative and postoperative complications including wound leaks, retinal detachment, choroidal hemorrhage and endophthalmitis were recorded as main outcome measures.
371 complete charts were reviewed. One hundred and seven individuals had surgery for epiretinal membrane peeling, 40 for macular hole repair, and 224 for primary repair of rhegmatogenous retinal detachment. One hundred and eighteen (31.8%) were pseudophakic and 30 (8.1%) required intra-operative suturing of scleral ports for leakage. Nineteen cases (5.1%) of combined cataract surgery were included and 48 (12.9%) individuals had prior laser/ cryo retinopexy. Twenty three (6.2%) patients had prior vitreoretinal surgery and 3 (0.8%) had prior ocular trauma. Seven (1.9%) patients had a past history of glaucoma with two patients (0.5%) having had a prior guarded filtration procedure. Thirty (8.1%) individuals required intraoperative suturing of scleral ports for leakage and 19 (5.1%) had subsequent retinal detachment. Of those who had subsequent retinal detachment, 4 (0.01%) had epiretinal membrane peeling, 3 (0.008%) had macular hole repair and 12 (0.03%) had a primary repair of retinal detachment. No cases of supra-choroidal hemorrhage were present and one case of endophthalmitis (0.3%) was noted. Mean follow-up was 4.9 (+/- 7.1) months.
This series of 25-gauge vitrectomy for epiretinal membrane peeling, repair of macular hole and primary rhegmatogenous retinal detachment had a similar complication profile as published studies involving a traditional 20-gauge surgical approach.
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