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Brock Alonzo, Steven T Bailey, Dongseok Choi, Christina J Flaxel; 23 and 25 gauge pars plana vitrectomy have similar rates of clinically significant complications. Invest. Ophthalmol. Vis. Sci. 2016;57(12):4483.
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© ARVO (1962-2015); The Authors (2016-present)
There are limited studies comparing surgical complication rates using 23 vs. 25 gauge Pars Plana Vitrectomy (PPV) instruments. This study seeks to determine any differences in clinically significant complications between the use of these instruments, which will influence and aid the vitreoretinal surgeon in the optimal instrument selection during future PPV surgeries. PPV is commonly performed during surgical repair of retinal detachments, non-resolving vitreous hemorrhage, endophthalmitis, epiretinal membranes, macular hole, intraocular foreign bodies, and many others. Major complications of PPV include hemorrhage, infection, and retinal detachment, and development of visually significant cataract or epiretinal membrane.
We completed an Institutional Review Board approved retrospective chart review of all patients (188) who underwent Pars Plana Vitrectomy (PPV) from 1/3/2013 to 1/30/2014 at the Casey Eye Institute/Oregon Health & Science University. Demographic data, indication for PPV, and surgical complications by standard clinical evaluation were reviewed. Patients were excluded if minimum follow up time was less than three months or if patients had undergone PPV in the past. Standard statistical analysis was used to evaluate the data.
A total of 188 patients were reviewed. 25 patients were excluded due to follow-up < 3 months or prior PPV in the past. Demographic data, indication for PPV, and past ocular history were similar in both groups (chi-square test, p-value > 0.05). 23 gauge PPV were performed more frequently than 25 gauge PPV (29 vs 134 patients, respectively). Complications included cataracts requiring surgical intervention, visually significant epiretinal membrane, choroidal hemorrhage, tractional retinal detachment, retinal re-detachment, and secondary open-angle glaucoma. Complication rates were not statistically different between the groups (chi-square test, p-value = 0.33).
This study suggests that there are is no significant difference in the rate of clinically relevant complications between 23 and 25 gauge PPV instruments. Limitations of this study include a relatively small sample size, low complication rate. 23 gauge PPV were also much more commonly performed at this institution. Further larger studies using prospective clinical trials are needed to better determine differences in complication rates.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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