Influences of 27-Gauge Vitrectomy on Corneal Topographic Conditions

Abstract

Purpose. To evaluate the influences of 27-gauge vitrectomy on corneal topographic conditions. Method. Fifty-six eyes of 56 patients undergoing 27-gauge vitrectomy were retrospectively studied. Twenty-three eyes with epiretinal membrane (ERM), 23 eyes with macular hole (MH), and 10 eyes with proliferative diabetic retinopathy (PDR) were included. Forty-five of the 56 eyes underwent 27-gauge phacovitrectomy (group 1), and the remaining 11 eyes underwent 27-gauge vitrectomy alone (group 2). Corneal topography was obtained with a wave-front analyzer preoperatively and at 1 and 3 months postoperatively. The corneal topographic parameters evaluated were the average corneal power, regular astigmatism, spherical aberration, and higher-order aberration (HOA). Results. In between-group analyses of groups 1 and 2, no significant differences were observed regarding the changes of the 4 parameters from the baseline to 1 and 3 months postoperatively. No significant differences in the changes of all parameters from the baseline to 1 and 3 months postoperatively were also observed between MH group and the other two groups. A significant difference in the change of HOA from the baseline to 1 month postoperatively was observed between ERM and PDR group however, the difference disappeared at 3 months. Conclusion. 27-gauge vitrectomy did not induce substantial changes in the corneal topographic conditions.

Corneal shape changes after vitreoretinal surgery with fluid–gas exchange

“…However, it has been reported that the corneal shape changes after surgery [16,17] . In contrast, many other reports have stated that there were no changes in the postoperative corneal shape that occurred when using 23-, 25-, and 27-gauge small incision vitrectomy [1–5] . In our current study, changes in the higher-order irregular astigmatism component of the corneal shape were even transiently observed in the nongas group on the day after the operation.…”

“…It has been previously reported that corneal shape changes that occur after vitreous surgery may be due to scleral wound closure, changes in the intraocular pressure, and the effects of intraocular inflammation. [2,4,8,16,17] In a study that used a 20-gauge vitreous surgery system for rhegmatogenous retinal detachment with gas replacement, the aqueous flare intensity after vitrectomy for retinal detachment was found to decrease to a stable level at 3 months postoperatively, although it remained significantly higher as compared to the normal levels. [22] A multiple regression analysis revealed that the aqueous flare intensity at 3 months postoperatively was significantly correlated with the size of the retinal breaks and the number of laser photocoagulation spots.…”

Comparison of 23 gauge transconjunctival releasable Suture Vitrectomy with standard 20 gauge Vitrectomy

“… 15 These sutures may lead to higher incidence of post operative astigmatism. 16 This surgically induced astigmatism is temporary and usually returns back to preoperative values at four months post op. 17 , 18 It was also reported by Park and Shao in separate studies that surgically induced astigmatism was considerably less for 23 G vitrectomy as compared to 20 G vitrectomy.…”

Complications in Retinal Surgery: A Review of Corneal Changes Following Vitreoretinal Procedures

“…Postoperative astigmatism following PPV has been largely attributed to the use of scleral cautery and suturing 58–60. During the immediate postoperative period, vitrectomies can induce corneal astigmatism of 0.3 to 2.92 D49,61,62 due to an increase in corneal steepening in an asymmetric and irregular configuration 61.…”

“…During the immediate postoperative period, vitrectomies can induce corneal astigmatism of 0.3 to 2.92 D49,61,62 due to an increase in corneal steepening in an asymmetric and irregular configuration 61. While this can negatively impact the visual outcomes in the immediate postoperative period, they tend to resolve by 4 months after surgery 46,47,58,60,61. These astigmatic changes are more likely to occur with larger gauge surgeries.…”