Abstract
Purpose: :
To review the surgical outcomes of 25 gauge vitrectomy in a busy Midwestern Retina practice and compare it to 20g vitrectomy results.
Methods: :
We are presenting a retrospective chart review of more than 228 cases. The cases are from three surgeons at two different hospitals and three surgery centers.
Results: :
. Pre–operative diagnoses were as follows: epiretinal membrane 33%, macular hole 18%, proliferative diabetic retinopathy 17%, retinal detachment 10%, and vitreous hemorrhage with no proliferative diabetic retinopathy 7%. Vision prior to surgery ranged from 20/20 to light perception. There were 54 patients with vision better than 20/50 before surgery. Post operative day 1, 7, and 30, there were 13, 72, and 101 patients respectively whose vision was better than 20/50. The intraocular pressures ranged from 8–35 pre–op with an average of 16. Post operative days 1, 7, and 30 had average intraocular pressures of 12, 13, and 13 mm Hg. On post operative day one 37% had pressure between 0–9 and less than 10% had pressure than 5 mm Hg. Post–op day 7 demonstrated 10% of patients with IOP of 0–9 and only 1% of patients had a pressure of <5 mm Hg. There were three cases of endophthalmitis. Two of the eyes grew out Staphylococcus epidermidis and one was culture negative. The presence or absence of an air–fluid exchange was not related to post–op hypotony. The complications that occurred less than six weeks after surgery, were hypotony, endophthalmitis, and returning to the operating room. There were two sclerotomies closed during surgery and three patients had to return to the operating room to close the sclerotomy. The complications that were from 6 weeks to 6 months were that one patient developed a retinal detachment, and there were two eyes that developed peripheral tears.
Conclusions: :
We feel that the large number of cases that we have complied utilizing 25g vitrectomy demonstrates that it is a safe and effective procedure, it allows for a rapid return in vision, the patients experience less post–operative pain, and that the instances of endophthalmitis is not greater than in 20 gauge vitrectomy.
Keywords: vitreoretinal surgery