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N. Kunjukunju, M. von Fricken, G. Ko, C. Weber; Comparing 25-Gauge Transconjunctival Sutureless Vitrectomy to 20-Gauge Vitrectomy for the Repair of Primary Rhegmatogenous Retinal Detachment. Invest. Ophthalmol. Vis. Sci. 2008;49(13):5238. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To compare anatomically and visually the complications of 25-gauge transconjunctival sutureless vitrectomy (TSV) versus conventional 20-gauge vitrectomy for the management of primary RRD by one surgeon at a single institution.
A retrospective comparative analysis of 125 consecutive eyes from 125 patients with a minimum of three months follow-up. Patients underwent primary vitrectomy (PPV) with fluid air exchange, gas tamponade and laser retinopexy. Excluded were eyes with prior scleral buckle, vitreous surgery, failed pneumatic retinopexy and eyes with giant tears, greater than grade C proliferative vitreoretinopathy and inadequate follow-up. 64 patients underwent 25-gauge TSV and 61 patients underwent 20-gauge PPV from September 2004 to April 2007.
Demographic and pre-operative characteristics were similar in both groups. Single operation success rate with one procedure was 58/64 (90.6%) for 25-gauge cases and 56/61 (91.8%) for 20-gauge cases, Fisher’s Exact Test (p=0.801). All cases were attached at final follow-up and the anatomic success rate was 100% for both groups. Pre-op BCVA was 20/125 and 20/169 for 25-gauge and 20-gauge cases respectively (p > 0.5). For the 3-month follow-up, mean BCVA was 20/35 and 20/39 for the 25-gauge and 20-gauge cases (p> 0.5) and the final follow-up mean BCVA was 20/34 and 20/36 for the 25-gauge and 20-gauge groups (p > 0.6). The mean pre-operative BCVA for both groups was logMAR 0.401 and final post-operative BCVA was logMAR 0.169 (p < 0.0005). Two cases in the 25-gauge group were complicated by hypotony that resolved quickly and one case developed postoperative choroidal hemorrhage and vitreous hemorrhage. In the 20-Gauge group there was one case of sterile endophthalmitis and one case of dense vitreous hemorrhage.
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