Safety of 25 Gauge 3 Ports Pars Plana Vitrectomy

Abstract

Abstract: : Purpose: To assess the feasibility and the safety of vitrectomy with the 25 Gauge system in macular surgery. Methods: 37 eyes with epimacular membrane were operated on by 8 experienced vitreoretinal surgeons in 4 centers, under local anesthesia. All surgeons had done 3 to 5 25 Gauge vitrectomies prior to the study. Surgical procedure included a 3–port pars plana vitrectomy after installation of 3 transconjunctival trocards, using the Accurus (Alcon inc., USA) and the 25 Gauge kit. Removal of the epimacular membrane was done with disposable (Alcon–Grieshaber, USA) or reusable (DORC, Netherlands) 25 Gauge forceps. Clinical evaluation was based on the occurence of complications during or following surgery. Results: In all cases, the membrane was removed. In some cases, inner limiting membrane was removed with the membrane or after the membrane. No intracular dye was used. Intraocular complications were limited to one case of extramacular retinal break with the forceps. A learning curve was noted by all surgeons, related to the technique and the flexibility of the instruments, especially forceps. Postoperative complications were 2 cases of early postoperative intraocular bleeding. No cases of hypotony, leakage of the sclerotomies, choroidal detachment, retinal break, retinal detachment or endophtalmitis were observed during the 3 months post operative follow–up. Conclusions: Vitrectomy with the 25 Gauge system appears to be safe when used by experienced vitreoretinal surgeons. No severe complications were observed during follow–up in our series of 37 vitrectomies.

Keywords: vitreoretinal surgery • macula/fovea