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C.J. Mohr, B. Davidson, L. Akduman, D.H. Lee; Comparison of 20 gauge versus 25 gauge Vitrectomy for the Treatment of Disabling Vitreous Floaters . Invest. Ophthalmol. Vis. Sci. 2004;45(13):1954.
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Purpose: The effectiveness and safety of pars plana vitrectomy for disabling floaters, secondary to posterior vitreous detachment, using 20 gauge versus 25 gauge vitrectomy instruments was compared. Patient comfort and satisfaction with each technique was also studied. Methods: Thirteen patients (16 eyes) underwent pars plana vitrectomy for disabling vitreous floaters. Pre–operative and postoperative best corrected visual acuity (BCVA), associated ocular conditions, resolution of the floaters and complications were noted. The subjects also completed a survey including preoperative and postoperative symptomatology, resolution of symptoms, and satisfaction with surgery. Results: The first 9 eyes underwent 20 gauge vitrectomy with retrobulbar anesthesia and the last 7 eyes had 25 gauge vitrectomy with topical anesthesia, except for one case of general anesthesia. Follow–up time varied between 2 to 24 months (median 8 months). Associated preoperative ocular conditions included: previous retinal detachment repair (5 eyes), age–related macular degeneration (2 eyes), diabetic retinopathy (1 eye), cystoid macular edema (1 eye) and cataract (1 eye). Four eyes were phakic and 12 eyes were pseudophakic. Pre–operative vision was 20/20 to 20/70 (median 20/30). Postoperative vision remained within two lines of preoperative vision in all but 3 cases. In one case BCVA improved after decreasing CME, and in the other two cases BCVA decreased due to progression of cataract and AMD. No other complications were noted. Although all patients had resolution of their preoperative subjective complaints with an overall increased level of functioning stated in the survey, the 25 gauge technique was markedly superior in regards to patient comfort and satisfaction. Conclusions: Our results suggest that pars plana vitrectomy is a viable option in the treatment of patients with disabling vitreous floaters. 25 gauge vitrectomy is superior to 20 gauge vitrectomy in regards to patient comfort and satisfaction. Long–term complications should be studied in a larger series.
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