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J. Lee, M. Shin, H. Y. Choi, B. S. Oum; Comparison Between 20-Gauge and 23-Gauge System in Primary Vitrectomy for Rhegmatogenous Retinal Detachment. Invest. Ophthalmol. Vis. Sci. 2008;49(13):5242.
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To compare 20-gauge (G) and 23G vitrectomy system regarding efficacy, anatomical results and functional outcomes in primary vitrectomy for rhegmatogenous retinal detachment.
Consecutive case series of primary vitectomy for rhegmatogenous retinal detachment with 20G standard pars plana vitrectomy and 23G transconjunctival sutureless vitrectomy without scleral buckling were reviewed retrospectively. Retinal detachment related with trauma, macular hole, and combined buckling procedure was excluded. Clinical findings, visual acuity, operation time, intra- or postoperative complications and anatomical results were compared.
Among 63 eyes of 62 patients, 36 eyes of 35 patients underwent 20G vitrectomy and 27 eyes underwent 23G vitrectomy. No difference were found between two groups in preoperative characteristics of retinal detachment including locations, size and numbers of breaks, area of detachment, vitreous hemorrhage and complicated proliferative vitreoretinopathy. Concurrent phacoemulsification for cataract was performed in 17 eyes (47%) of the 20G group and 22 eyes (82%) of the 23G group.Anatomical success rate after a single operation was 83.3% in 20G and 92.5% in 23G (p=0.274). Visual acuity improvement of logMAR 0.2 or more was obtained in 28 eyes (78%) and 19 eyes (70%) respectively (p=0.503). Operation time of 23G vitrectomy was 82.6 minutes in average and it was significantly shorter than 102.5 minutes of 20G vitrectomy (p=0.002). The difference was significant regardless of the concurrent cataract surgery. No significant difference was found in intra- and postoperative complications between two groups. Anatomical success was obtained in all eyes after additional operations.
23G transcunjunctival sutureless vitrectomy achieved comparable outcomes with 20G vitrectomy in repair of rhegmatogenous retinal detachment had shorter operation time. It is considered as a viable alternative to 20G vitrectomy.
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