25-gauge, sutureless vitrectomy and standard 20-gauge pars plana vitrectomy in idiopathic epiretinal membrane surgery: a comparative pilot study

Rizzo, Stanislao; Genovesi-Ebert, Federica; Murri, S; Belting, Claudia; Vento, Andrea; Cresti, Federica; Manca, Maria Laura

doi:10.1007/s00417-005-0173-6

Cited by 200 publications

(157 citation statements)

References 20 publications

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“…However, other studies have shown quicker visual recovery and fewer complications with small-gauge trans-conjunctival sutureless vitrectomy techniques for ERM removal. [14][15][16] One of the limitations of this study was the use of VA as the sole measure of surgical success. Metamorphopsia is also a significant contributor to morbidity in patients with ERMs and it has been shown that, even though VA alone may not improve following ERM removal, metamorphopsia and quality of life does.…”

Section: Discussionmentioning

confidence: 98%

Visual acuity outcomes following surgery for idiopathic epiretinal membrane: an analysis of data from 2001 to 2011

Dawson

Shunmugam

Williamson

2013

Eye

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Purpose Pars plana vitrectomy (PPV) is commonly used to remove the epiretinal membrane (ERM), but the timing of surgical intervention guided by visual acuity (VA) performance at presentation is uncertain. Patients and methods Prospectively entered clinical data of 237 patients on an electronic patient record from 2001 to 2011 were analysed to determine visual outcomes, in particular in relation to pre-operative VA.Results The mean age of the patients was 68.8 years and 54.4% were female. Median follow-up was 0.55 years. The median pre-operative logMAR VA was 0.60 (SD 0.48-0.78, Snellen equivalent 6/36) and post-operative VA was 0.30 (SD 0.18-0.60, 6/12, Po0.005). Pre-operative VA correlated with post-operative VA (linear R 2 ¼ 0.22, Po0.0001). In all, 69.6% of patients showed an improvement in VA, 15.2% showed no change, and the condition of 15.2% worsened. The number of patients with an improvement in logMAR VA of more than 0.3 was greatest in those who had a pre-operative VA of 1.0 (6/60) or worse, followed by those in the range of 0.6-0.9 and then those with preoperative VA of 0.5 or better (Po0.001). The proportion of patients with visual improvement of logMAR VA of more than 0.3 increased statistically with progressing years (P ¼ 0.019). Conclusion In conclusion, this study shows improvement in VA after PPV and ERM removal. Patients with better initial VA achieve higher levels of visual outcome but those with poorer pre-operative VA show a greater change in VA following ERM surgery. Results of surgery improved over the time period of the study.

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Section: Discussionmentioning

confidence: 98%

Visual acuity outcomes following surgery for idiopathic epiretinal membrane: an analysis of data from 2001 to 2011

Dawson

Shunmugam

Williamson

2013

Eye

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“…[3][4][5][6][7][8][9][10][11][12] Furthermore, a few recent reports continue to prove the superiority of MIVS in direct comparison with conventional 20-gauge vitrectomy. 6,7,[14][15][16][17] Although the makers of each of two commercially available small gauges, 25 and 23 gauges, claim to offer the safest and best product, no studies have yet compared the 25-and 23-guage systems.…”

Section: Discussionmentioning

confidence: 99%

“…MIVS shortens operative time and facilitates postoperative recovery. [4][5][6][7][8][9][10][11][12] This 25-gauge sutureless system, however, was useful only in cases of relatively simple vitreoretinal pathology owing to limitations in cutter performance and a lack of necessary accessory instruments. In 2005, Eckardt developed 23-gauge sutureless vitrectomy using an obliquely entering trocar cannular system.…”

Section: Introductionmentioning

confidence: 99%

Comparison of 25- and 23-gauge sutureless microincision vitrectomy surgery in the treatment of various vitreoretinal diseases

Nam

Chung

Lee

et al. 2009

Eye

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Purpose To compare the effectiveness and safety of 25-and 23-gauge sutureless microincision vitrectomy surgery (MIVS) in the management of various vitreoretinal diseases. Methods Eighty-five consecutive patients undergoing sutureless vitrectomy during January to April 2008 were randomized to either 25-or 23-gauge MIVS. Data collected prospectively included best-corrected visual acuity (BCVA), operation time, postoperative visual recovery, postoperative anterior segment change, and complications. Results The most common indications for MIVS were macular hole, macular pucker, vitreous haemorrhage, and diabetic traction retinal detachment. Mean operation times of the 25-gauge (n ¼ 38) and 23-gauge groups (n ¼ 47) were 33.68 and 34.47 min, respectively (P ¼ 0.942). Mean BCVA improved significantly in both the 25-and 23-gauge groups when measured 3-month postoperatively. There was no between-group difference in either the degree or the rate of postoperative visual recovery. Seven patients in the 23-gauge group, compared with three in the 25-gauge group, required suturing of sclerotomy at the end of the surgery. No patients in either group developed postoperative wound leakage or endophthalmitis. Conclusion Our prospective study suggests that, within the limited indications, both 25-and 23-gauge MIVS are equally effective, with similar safety profiles. Gauge selection thus may be made according to a surgeon's preference and the availability of appropriate instruments.

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“…Pars plana vitrektomi (PPV) ilk kez 1971 y›l›nda Machemer taraf›ndan uygulanm›flt›r (1) 25-G TSV'nin epiretinal membran ve makula deli¤i gibi vitreomaküler yüzey hastal›klar›, vitreus hemorajisi, proliferatif vitreoretinopatiyle komplike olmayan retina dekolman› ve yayg›n vitreus diseksiyonu gerektirmeyen traksiyonel diyabetik retina dekolman›nda uygulanabilece¤i bildirilmifltir (6)(7)(8)(9)(10). Biz de çal›flmam›zda, idiyopatik makula deli¤i tedavisinde 25-G TSV'nin etkinli¤ini ve güvenilirli¤i-ni araflt›rd›k.…”

Section: Giriflunclassified

“…Ayr›ca kullan›lan mikrokanül sistemi, enstrümanlar›n göz içine tekrarlayan girifllerinin neden olaca¤› hasara karfl› girifl yerini korur. küçük olmas› nedeniyle, retina fototoksik etkiye daha az maruz kal›r (10,14). ‹diyopatik makula deli¤i tedavisinde 25-G TSV, ILM soyulmas› ve intraoküler CF38 gaz tamponad› uygulanan 84 gözün incelendi¤i bir çal›flmada, makula deli¤i kapanma oran› %93 olarak bildirilmifltir.…”

Section: Tart›flmaunclassified

25-Gauge Transconjunctival Sutureless Vitrectomy for Idiopathic Macular Hole

Yanyalı¹,

Dinçyildiz²,

Çelik³

et al. 2010

tod

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25-gauge, sutureless vitrectomy and standard 20-gauge pars plana vitrectomy in idiopathic epiretinal membrane surgery: a comparative pilot study

Cited by 200 publications

References 20 publications

Visual acuity outcomes following surgery for idiopathic epiretinal membrane: an analysis of data from 2001 to 2011

Visual acuity outcomes following surgery for idiopathic epiretinal membrane: an analysis of data from 2001 to 2011

Comparison of 25- and 23-gauge sutureless microincision vitrectomy surgery in the treatment of various vitreoretinal diseases

25-Gauge Transconjunctival Sutureless Vitrectomy for Idiopathic Macular Hole

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