Comparison of One-year Outcomes between 23- and 20-gauge Vitrectomy for Preretinal Membrane

Hikichi, Taiichi; Matsumoto, Naomi; Ohtsuka, Hideo; Higuchi, Makoto; Matsushita, Takuro; Ariga, Hiroko; Kosaka, Shyoko; Matsushita, Reiko

doi:10.1016/j.ajo.2008.10.009

Cited by 67 publications

(58 citation statements)

References 18 publications

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“…6,11,12,23 All in all, single-session 23-gauge ppv with b-MICS yields excellent results equivalent to those of conventional twostep procedures in the treatment of macular hole with cataract.…”

Section: Discussionmentioning

confidence: 95%

23- vs 20-gauge pars plana vitrectomy in combination with bimanual microincisional cataract surgery (b-MICS) for the treatment of macular hole and cataract as a one-step procedure

2013

Eye

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Background/aims 23-gauge pars plana vitrectomy (ppv) is a new method for vitreoretinal surgery. It may reduce operation time, the risk of complications, and patient discomfort, especially in combination with simultaneous bimanual microincisional cataract surgery (b-MICS). Methods Seventy-five consecutive patients who underwent combined cataract surgery and ppv at our center between 1 January 2008 and 31 December 2010 were included. The first 36 patients were treated with 20-gauge ppv, the following 39 patients with 23-gauge ppv. Study end points 8 weeks after surgery were duration of the procedure, improvement of visual acuity, and occurrence of complications. Results Duration of surgery was reduced in 23-vs 20-gauge ppv (54.0 ± 11.6 vs 61.0 ± 19.0 min, P ¼ 0.08). Visual acuity improved significantly in both the groups (20-gauge: logMAR 0.750±0.304 before and 0.369±0.273 after surgery; 23-gauge: logMAR 0.663±0.340 before and 0.339±0.273 after surgery). There were no appreciable group differences in baseline or post-treatment visual acuity. Conclusions 23-gauge ppv in combination with b-MICS is a suitable, safe, and effective method for the treatment of combined cataract and vitreo-retinal diseases. The procedure is somewhat shorter and patient discomfort during and after surgery is improved. In terms of efficacy and safety, 23-gauge ppv is equivalent with conventional 20-gauge ppv.

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Section: Discussionmentioning

confidence: 95%

23- vs 20-gauge pars plana vitrectomy in combination with bimanual microincisional cataract surgery (b-MICS) for the treatment of macular hole and cataract as a one-step procedure

2013

Eye

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“…Given the position and direction of the vitreous cutter in conventional vitrectomy, some degree of perpendicular traction to the vitreous base cannot be avoided (Figure 1-A3). Considering the similar propensity for the incidence of PVD-related retinal break in macular surgery despite the evolution of the vitrectomy machine, 1,3,4,6,[8][9][10][11][12] the effect of increasing cut velocity may be limited. Some degree of artificial vitreous traction seems to be inevitable during peripheral vitreous removal.…”

Section: Discussionmentioning

confidence: 99%

Partial posterior hyaloidectomy for macular disorders

Kim

Kang

Kim

et al. 2013

Eye

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Purpose To evaluate the effect of partial posterior hyaloidectomy (PPH) in preventing iatrogenic retinal breaks related to the induction of a posterior vitreous detachment (IPVD) Methods Fifty-nine patients who necessitated IPVD for an epiretinal membrane or macular hole were included in this prospective, interventional case series. Extensive removal of vitreous gel, close to the retina, was conducted before IPVD under 23 G (gauge)-vitrectomy system. The PPH involved the limited extent of IPVD and limited removal of the outermost vitreous cortex to an area slightly beyond the margin of the temporal major vascular arcade. The incidence of retinal breaks related to the surgery was compared with 57 eyes that had undergone conventional 23-G total vitrectomy accompanied by extensive IPVD using w 2 -test. Results Patients were followed-up for a mean of 14.3 months (6-30 months) after the surgery. The incidence of peripheral retinal breaks after the PPH was 3.4% (2/59 eyes), which was significantly lower than that in the eyes that underwent conventional 23 G vitrectomy (15.8%, 9/57 eyes, P ¼ 0.023) for the same disorders that required an IPVD. No patient complained of postoperative floaters, postoperatively. Conclusions PPH would be an efficient procedure to prevent iatrogenic peripheral retinal breaks related to an IPVD.

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“…57,58 In a retrospective series of 177 consecutive 25G PPV cases, the incidence of intraoperative retinal breaks was 15.8 %. 59 In one comparative series of 25G and 20G vitrectomies, no statistically significant difference in the incidence of intraoperative retinal breaks was found. 60 …”

Section: Retinal Break Formationmentioning

confidence: 99%

Micro-incision Vitrectomy Surgery – Past, Present and Future

Nagpal¹,

Verma²,

Goswami³

2015

European Ophthalmic Review

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The advent of micro-incision vitrectomy surgery (MIVS) changed the approach, indications and complications of vitreoretinal surgeries forever. Since its introduction in 2002, MIVS has been gaining popularity amongst retinal surgeons for managing a wide variety of vitreoretinal disorders. MIVS allows for more efficient surgery, faster recovery time and better visual outcomes than 20G vitrectomy. The use of instrumentation having small diameters reduced trauma from conjunctival and scleral manipulation as well as post-operative inflammation and corneal astigmatism. Further refinement of techniques with the introduction of 27G for routine procedures increases the comfort for the patient and minimises the recovery time. In this review, we briefly summarise the journey of MIVS to its present status and discuss the various advances that have taken place to achieve better efficiency and results.

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Comparison of One-year Outcomes between 23- and 20-gauge Vitrectomy for Preretinal Membrane

Cited by 67 publications

References 18 publications

23- vs 20-gauge pars plana vitrectomy in combination with bimanual microincisional cataract surgery (b-MICS) for the treatment of macular hole and cataract as a one-step procedure

23- vs 20-gauge pars plana vitrectomy in combination with bimanual microincisional cataract surgery (b-MICS) for the treatment of macular hole and cataract as a one-step procedure

Partial posterior hyaloidectomy for macular disorders

Micro-incision Vitrectomy Surgery – Past, Present and Future

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