25-Gauge Macular Surgery

Patelli, Fabio; Radice, Paolo; Zumbo, G.; Frisone, Giampiero; Fasolino, Giuseppe

doi:10.1097/iae.0b013e31802c5125

Cited by 51 publications

(10 citation statements)

References 25 publications

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“…For all diagnostic pathology, the IOP decreased more in the first group of patients. The IOP got back to normal after one month and the differences between the groups were not significant 19,20,30,36. Hypotony, even if transient, is not a benign condition and may increase the risks of serious complications postoperation, including retinal or vitreal incarceration, suprachoroidal hemorrhage, and endophthalmitis 18,37.…”

Section: Discussionmentioning

confidence: 96%

Differences between the combination of the 25-gauge vitrectomy with phacoemulsification versus 20-gauge vitrectomy and phacofragmentation

Romero-Aroca

Almena-Garcia²,

Baget-Bernaldiz³

et al. 2009

OPTH

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Introduction:In the present study we determine the differences observed between 25-gauge-vitrectomy combined with phacoemulsification, and the 20-gauge-vitrectomy combined with pars plana phacofragmentation.Methods:A prospective study of a sample of 987 eyes of 661 patients randomly divided into two groups. 25-gauge-vitrectomy plus phacoemulsification included 486 eyes, and 20-gauge-vitrectomy plus phacofragmentation 501 eyes. We evaluated the differences at the time of the surgery, the intra-and postoperative complications, and the variations in intraocular pressure.Results:The final visual outcome was similar in both groups. The most important differences between groups were: surgical time was faster in group 1 than in group 2, (mean time: 35.16 ± 3.49, 44.74 ± 5.30 minutes). Intraoperative complications were more numerous in group 1. In group 1, postoperative low levels of intraocular pressure are present in all patients with 2.77% of patients with hypotension (<8 mmHg), and three choroidal effusion. In group 2, intraocular lens decentration and retinal detachment are more frequent (2.38% and 1.39%, respectively).Conclusions:In the present study, both techniques have a similar number of complications and have a similar postoperative outcome, and are valid for the management of the pathologies selected.

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Section: Discussionmentioning

confidence: 96%

Differences between the combination of the 25-gauge vitrectomy with phacoemulsification versus 20-gauge vitrectomy and phacofragmentation

Romero-Aroca

Almena-Garcia²,

Baget-Bernaldiz³

et al. 2009

OPTH

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“…The incidence of retinal breaks in 20-G vitrectomy in MH surgery was found to be between 0% and 7.2% [34-36]. In 23- or 25-gauge vitrectomy incidences were reported to be 0% to 3.1% [6,7,37,38]. Using smaller gauge instruments might decrease trauma in and near the vitreous base adjacent to the sclerotomies.…”

Section: Discussionmentioning

confidence: 99%

Effect of prophylactic 360° laser treatment for prevention of retinal detachment after phacovitrectomy: (Prophylactic 360° laser treatment for prevention of retinal detachment)

Iwase

Oveson

2013

BMC Ophthalmol

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BackgroundTo investigate the effect of intraoperative 360° laser retinopexy anterior to the equator for the prevention of retinal detachment after phacovitrectomy.MethodsThe patients were part of two consecutive case series cohorts in macular hole (MH) and rhegmatogenous retinal detachment (RRD), one which did not receive intraoperative prophylactic 360° laser, and one which received intraoperative prophylactic 360° laser. For the 360° laser treatment group, three rows of medium-white burns were positioned anterior to the equator. The baseline characteristics and the risk of retinal detachment over time were analyzed and compared between the groups.ResultsProphylactic intraoperative 360° laser treatment was performed on 77 MH cases (67.3 years) and compared to a control group of 35 MH cases (65.8 years). Additionally, prophylactic intraoperative 360° laser treatment was performed on 108 RRD cases (64.0 years) and compared to 270 RRD cases (64.4 years). The 360° laser group showed a significant reduction (0%, 0/77 eyes) in the rate of the incidence of retinal detachment after vitrectomy at 12 months after surgery in MH cases, compared with the control group (5.7%, 2/35 eyes) (p = 0.034). Kaplan-Meier survival analysis demonstrated that the rate of retinal detachment in the control group was significantly higher than that in the 360° laser group (p = 0.035). There was no significant difference between the groups in RRD cases (p = 0.092).ConclusionsIntraoperative 360° laser retinopexy following phacovitrectomy resulted in a significant reduction in the rate of postoperative retinal detachment in MH cases.

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“…In the 25-gauge one, this incidence has a mean of 13% between articles [7,57,58,59]. Of note, the upper limit of hypotony in each study is different: de Preobrajensky et al [55] define hypotony at a level of 5 mm Hg or less, Romano et al [52 ]at 6 mm Hg or less, Oshima et al [59 ]at 7 mm Hg or less, Patelli et al [60 ]at 8 mm Hg or less, Schweitzer et al [56] at 9 mm Hg or less, and Wimpissinger et al [27 ]at 10 mm Hg or less.…”

Section: Discussionmentioning

confidence: 99%

Safety of 20-Gauge Transconjunctival Sutureless Vitrectomy

Papaefthymiou

Petropoulos²,

Mangioris³

et al. 2013

Ophthalmologica

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Purpose: To study the safety of 20-gauge transconjunctival sutureless vitrectomy. Methods: Clinical data of patients who underwent 20-gauge transconjunctival sutureless vitrectomy for the first time, for various disorders, were reviewed retrospectively. The main outcome measures were the number of sclerotomies requiring suturing as well as the intra- and postoperative complications. Results: A total of 179 operations were performed. Indications for vitrectomy included 68 idiopathic epiretinal membranes, 26 macular holes, 23 phakic and 16 pseudophakic retinal detachments, and 46 various other, less common etiologies. Of these 179 operations, 166 (93%) were sutureless. Of the 537 sclerotomies created, 25 (5%) received a single transconjunctival-scleral suture. Intraoperative complications included premature dislodging of the cannulas in 2 sclerotomies and an iatrogenic horseshoe tear at 1 sclerotomy site. Postoperative complications comprised transient hypotony in 14 cases, subconjunctival gas in 2 cases, and choroidal effusion in 1 case. No serious complications (such as endophthalmitis) were observed. Conclusion: 20-gauge transconjunctival sutureless vitrectomy can be considered safe, as the intra- and postoperative complications observed are neither numerous nor significant. Sclerotomies appear to be safe and relatively easy to perform, without compromising the advantages of sutureless surgery.

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25-Gauge Macular Surgery

Abstract: 25-Gauge vitrectomy is a safe and effective procedure for macular surgery. The absence of intraoperative complications and relatively low rate of postoperative complications suggest that this technique is safe and effective for treating macular conditions.

Cited by 51 publications

References 25 publications

Differences between the combination of the 25-gauge vitrectomy with phacoemulsification versus 20-gauge vitrectomy and phacofragmentation

Differences between the combination of the 25-gauge vitrectomy with phacoemulsification versus 20-gauge vitrectomy and phacofragmentation

Effect of prophylactic 360° laser treatment for prevention of retinal detachment after phacovitrectomy: (Prophylactic 360° laser treatment for prevention of retinal detachment)

Safety of 20-Gauge Transconjunctival Sutureless Vitrectomy

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