25 vs. 27-gauge micro-incision vitrectomy surgery for visually significant macular membranes and full-thickness macular holes: a retrospective study

Abstract

Background To evaluate visual and safety outcomes for 25-gauge (25G) and 27-gauge (27G) micro-incision vitrectomy platforms (MIVS) for the treatment of epiretinal membrane and full-thickness macular holes. Methods Retrospective analysis of all patients who underwent internal limiting membrane (ILM) peel surgery from January 2017 through December 2018. 207 cases met the eligibility criteria for inclusion. Primary endpoint was post-operative Best-Corrected Distance Visual Acuity (BCVA) at 6 months. Results For all patients combined, mean logMAR BCVA improved from 0.57 (± 0.40) to 0.37 (± 0.36) post-operatively (p < 0.001). For 25G ERMs, logMAR BCVA improved from 0.51 (± 0.28) to 0.30 (± 0.25) post-operatively (p < 0.001). For 27G ERMs, logMAR BCVA improved from 0.33 (± 0.28) to 0.28 (± 0.27) post- operatively (p = 0.15). For 25G FTMHs, logMAR BCVA improved from 0.87 (± 0.48) to 0.51 (± 0.44) post-operatively (p < 0.001). For 27G FTMHs, logMAR BCVA changed from 0.89 (± 0.47) to 0.96 (± 0.60). Conclusion Final visual outcomes improved for both 25G and 27G ERM groups and the 25G FTMH group. Both 25G and 27G were safe and well tolerated MIVS platforms for the treatment of ERM and FTMH.

27‐gauge microincision vitrectomy surgery compared with 25‐gauge microincision vitrectomy surgery on wound closure and need for wound suture and other postoperative parameters in the treatment of vitreoretinal disease: A meta‐analysis

“…A total of 1687 relevant studies were screened, of which 15 studies between 2015 and 2021, met the inclusion criteria and were involved in the meta-analysis. [9][10][11][12][13][14][15][16][17][19][20][21][22][23][24] Data obtained from these studies were shown in Table 2.…”

“…The current meta‐analysis involved 1264 subjects with the vitreoretinal disease at the baseline of the studies; 562 of them were using the 27‐gauge microincision vitrectomy surgery, and 722 were using 25‐gauge microincision vitrectomy surgery 9‐17,19‐24 . The 27‐gauge microincision vitrectomy surgery subjects had a significantly lower intraoperative and postoperative wound complication, wound suture number, and best corrected visual acuity compared with 25‐gauge microincision vitrectomy surgery in subjects with vitreoretinal disease.…”

“…However, other studies found that because of the reduced flow rate, rhegmatogenous retinal detachment cases treated with 27‐gauge vitrectomy take longer to complete. In addition, due to sutureless incisions, 27‐gauge vitrectomy caused higher postoperative inflammation 18‐24 . So, this meta‐analysis was done to assess the effect of 27‐gauge microincision vitrectomy surgery compared with 25‐gauge microincision vitrectomy surgery on wound closure and the need for wound suture and other postoperative parameters in the treatment of vitreoretinal disease.…”

“…In addition, due to sutureless incisions, 27‐gauge vitrectomy caused higher postoperative inflammation. 18 , 19 , 20 , 21 , 22 , 23 , 24 So, this meta‐analysis was done to assess the effect of 27‐gauge microincision vitrectomy surgery compared with 25‐gauge microincision vitrectomy surgery on wound closure and the need for wound suture and other postoperative parameters in the treatment of vitreoretinal disease.…”

The Clinical and Safety Outcomes of 27 Gauge Pars Plana Vitrectomy in Eyes With Macular Hole

“…MH is a defect in the macula that can be caused by age, trauma, or vitreoretinal disease resulting in impaired central vision, metamorphopsia, and central scotoma [ 13 ]. Currently, the standard treatment of choice for MH is vitrectomy with posterior hyaloid face (PHF) removal with ILM peeling with tamponade agent but posturing is still a debatable topic [ 14 ]. Vitrectomy can be performed using different gauge cutters.…”