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Jie Li, Fang Li, Sanmei Liu, JIE ZHONG; Retrospective Comparison of 27-Gauge and 25-Gauge Microincision Vitrectomy Surgery for the Treatment of Primary Rhegmatogenous Retinal Detachment.. Invest. Ophthalmol. Vis. Sci. 2018;59(9):4239.
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© ARVO (1962-2015); The Authors (2016-present)
To retrospectively compare the safety and effectiveness of 27-gauge (27G) microincision vitrectomy surgery (MIVS) with 25-guage (25G) MIVS for treating primary rhegmatogenous retinal detachment (RRD).
One hundred and twenty-nine eyes of 129 patients with RRD underwent MIVS from May 1, 2015 to June 31, 2017 and were included in this study. Eighty-four eyes underwent 25G vitrectomy and 45 eyes for 27G vitrectomy, respectively. The analysis included characteristics of the patients, surgical time, main clinical outcomes, and rate of complications.
The mean surgical times was 69.9 ± 41.2 minutes for the 25G group and 61.7 ± 34.1 minutes for the 27G group, and there was no significant difference (p = 0.254) between the two groups. The primary anatomical success rate after a single operation was 96.4% and 91.1% for 25G group and 27G groups respectively (p = 0.388). Baseline and final visit BCVA were 1.88 ± 1.09 and 0.95 ± 0.75 in 25G group, and 1.68 ± 1.00 and 1.04 ± 0.79 in the 27G groups. Postoperative BCVA increased significantly in both groups (p < 0.001). However, there was no significant differences in terms of visual improvement (> 0.2 logMAR) ratio between the two groups (P = 0.177). No severe intraoperative complication was observed. Iatrogenic retinal breaks occurred in 2 eyes (2.4%) in the 25G group and 1 eye (2.2%) in the 27G group during the peripheral vitreous base shaving. The transient ocular hypertension (>25 mmHg) on day 1 postoperatively was 15.5% in 25G group, and 11.1% in 27G group, respectively (p=0.495).
This study found no significant anatomical or functional difference between 27G PPV and 25G PPV in the treatment of primary RRD. Therefore, 27G vitrectomy would be a safe and effective surgery for repairing of primary RRD.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
Fig. 1 Graph shows the time course of logMAR BCVA and IOP. a) Compared to preoperative BCVA, postoperative BCVA between 1 week and the last visit increased significantly in both groups (p < 0.001). b) The mean IOP at baseline was 10.4 ± 3.8 mm Hg in the 25G group and 11.4 ± 3.2 mm Hg in the 27G group. None of the differences in the IOP between the two groups was significant during follow-up. Compared to preoperative IOP, postoperative IOP were significant higher at each time point (p < 0.001).
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