June 2023
Volume 64, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2023
25 vs. 27-Gauge Vitrectomy for Visually Significant Macular Membranes and Full-Thickness Macular Holes
Author Affiliations & Notes
  • Henry He Li
    Case Western Reserve University, Cleveland, Ohio, United States
    Oregon Eye Consultants, Eugene, Oregon, United States
  • Kaitlyn Hunter
    Oregon Eye Consultants, Eugene, Oregon, United States
  • Andrew Clark Thomson
    Oregon Eye Consultants, Eugene, Oregon, United States
  • Allan A Hunter
    Oregon Eye Consultants, Eugene, Oregon, United States
  • Footnotes
    Commercial Relationships   Henry Li None; Kaitlyn Hunter None; Andrew Thomson None; Allan Hunter None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2023, Vol.64, 5263. doi:
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    • Get Citation

      Henry He Li, Kaitlyn Hunter, Andrew Clark Thomson, Allan A Hunter; 25 vs. 27-Gauge Vitrectomy for Visually Significant Macular Membranes and Full-Thickness Macular Holes. Invest. Ophthalmol. Vis. Sci. 2023;64(8):5263.

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      © ARVO (1962-2015); The Authors (2016-present)

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Purpose : Recent trends toward smaller surgical instruments has led to the creation of the 27-gauge (27G) Microincision Vitrectomy Surgery (MIVS) platform. This comparative study aims to further evaluate the visual and safety outcomes for 25-gauge (25G) vs. 27G MIVS systems for the treatment of epiretinal membrane (ERM) and full-thickness macular holes (FTMH) using a larger sample number to increase statistical power from our previous report.

Methods : A retrospective analysis of 582 patients who underwent internal limiting membrane peel or FTMH surgery from Jan 2017 to Jan 2022 was conducted. Primary endpoint was best-corrected visual acuity (BVCA) 6 months postoperatively. Secondary endpoint was intraocular pressure (IOP), central foveal thickness (CFT) and macular volume (MV) on OCT, surgical time, and post-operative complications. Statistical analysis performed with t-tests, Mann-Whitney U test, or Chi-square test when appropriate and p-value < 0.05 was considered statistically significant.

Results : For all patients combined, mean logMAR BCVA improved from 0.52 (± 0.38) to 0.39 (± 0.38) post-operatively (p < 0.001). For 25G ERMs, logMAR BCVA improved from 0.50 (± 0.28) to 0.32 (± 0.25) post-operatively (p < 0.001). For 27G ERMs, logMAR BCVA improved from 0.38 (± 0.27) to 0.31 (± 0.28) post- operatively (p = 0.1). For 25G FTMHs, logMAR BCVA improved from 0.89 (± 0.48) to 0.55 (± 0.44) post-operatively (p < 0.001). For 27G FTMHs, logMAR BCVA changed from 0.78 (± 0.43) to 0.56 (± 0.58). No statistically significant difference was observed between preoperative versus postoperative IOP, CFT and MV in 25G and 27G groups. Mean surgical time was shorter using 27G, 1.7 min shorter in the ERM group and 2.4 min shorter in the FTMH group. There were no serious complications in either group and no cases of endophthalmitis.

Conclusions : Both 25G and 27G were safe and well tolerated MIVS platforms for the treatment of ERM and FTMH. Future studies may aim to study a sample with longer follow-up or as a prospective study.

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.


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