Intra- and post-operative risk of retinal breaks during vitrectomy for macular hole and vitreomacular traction

Abstract

Background/Objective To evaluate the development of intra- and post-operative retinal breaks after pars plana vitrectomy (PPV) for macular hole (MH) and/or vitreomacular traction (VMT). Subjects/Methods Medical records of patients who underwent PPV at Kellogg Eye Center between 1/1/2005–6/30/2018, were evaluated in three groups: group 1, MH/VMT (n = 136); group 2, epiretinal membrane (ERM) without VMT (n = 270); and group 3, diagnostic vitrectomy (DV) or vitreous opacities (n = 35). Statistical analyses were conducted using SAS. Results 20.6% of patients with MH/VMT, 8.5% of patients with ERM, and 5.7% of patients with DV or vitreous opacities had either intra-operative or post-operative breaks. Indication of MH/VMT versus ERM was a significant predictor for this outcome (p = .0112). The incidence of retinal breaks was higher in operations using 23-gauge versus 25-gauge PPV (25.0% vs. 7.4%, p < .0001). Conclusions The presence of MH and/or VMT is a significant risk factor for retinal breaks from PPV, as is use of 23-gauge vitrectomy.

Minimally Invasive Vitreoretinal Surgery (25G, 27G) with High-speed Vitrectomy Cutter – Case Series

“…Additional technologies were implemented in this system, such as placing the opening closer to the vitrectomy tip or using a beveled tip, which allows safer work at a shorter port-to-surface distance. This is particularly impor- 53 tant in macular surgery, reducing the risk of iatrogenic retinal breaks [10].These improvements may also reduce the use of scissors or forceps during segmentation or delamination.…”