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M.J. Ward, L. Rao, F. Seffo, K. Jamal, S. Huang; Visual Recovery in Patients Undergoing 25–Gauge Transconjunctival Vitrectomy . Invest. Ophthalmol. Vis. Sci. 2006;47(13):4646.
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© ARVO (1962-2015); The Authors (2016-present)
This series evaluates visual recovery time in eyes undergoing 25–guage transconjunctival vitrectomy for a variety of posterior segment conditions.
A retrospective chart review of the first 98 consecutive patients (98 eyes) that underwent 25–guage vitrectomy using the Bausch & Lomb Millenium TSV 25 system by a single author (SH) for nonclearing vitreous hemorrhage (52), epiretinal membrane (13), TRD (9), vitreous opacities (8), rhegmatogenous retinal detachment (6), CRVO (5), endophthalmitis (2), ROP (1), BRAO (1), and BRVO (1) was performed. Best–corrected pre– and postoperative visual acuity were converted to logMAR values. The first postop visit in which visual acuity exceeded that of preoperative visual acuity was noted. Additional outcome measures were performed and included intraocular pressure, use of post–op glaucoma medications and postoperative complications.
The average time from surgery to achieve better than preoperative vision for all patients was 12.4 days (range1–77). Factors limiting recovery of vision following surgery included intraocular gas bubble (14/98), post–op VH (8/98), and macular ischemia (25/98); excluding these patients, mean time to achieve better than preoperative vision was 8.6 days (range 1–64). Of these patients, 61% had better than pre–op vision on the first post–op day and 82% by the first week visit. A total of 77/98 (78.5%) patients achieved better than preoperative vision at some point during their postoperative course. Mean preoperative visual acuity improved from 20/458 (range 20/20–LP, median 20/400, mode 2/200) to 20/102 (range 20/20–LP, median 20/50, mode 20/40) postoperatively (P<0.0001). Complications included retinal detachment (4/98), elevated IOP (18/98), and transient hypotony (9/98). Mean follow–up time was 128 days (range 7–761).
Rapid and highly significant visual recovery occurred in the absence of underlying vision–limiting pathology. Complications were rare and compared favorably with published literature on 20–gauge surgery. A comparative study evaluating visual recovery time in patients undergoing 20–gauge vitrectomy will be discussed.
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