Mechanical Property Comparison of 23-, 25-, and 27-Gauge Vitrectors across Vitrectomy Systems

Lai, James M; Patel, Veshesh; Watane, Arjun; Fils, Aaron J; Pakravan, Parastou; Huang, Chun Yuh; Patel, Nimesh A.; Sridhar, Jayanth; Yannuzzi, Nicolas A.

doi:10.1016/j.oret.2022.05.004

Cited by 4 publications

(3 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Surgeries performed with smaller incisions are associated with reduced scarring, increased accuracy, and lower risks of encountering intra- and post-operative complications [ 1 , 2 , 5 ]. The advantages and disadvantages of transitioning from 23-gauge to 25-gauge instruments are amplified with a progression from 25-gauge to 27-gauge instruments [ 12 , 13 ]. The small distance from the vitrector tip to the port facilitates aspiration of membranes (fibrovascular membranes for diabetic delaminations, epiretinal and PVR membranes after starting posteriorly with forceps) and retina during retinectomies.…”

Section: Discussionmentioning

confidence: 99%

Twenty-seven-gauge vitrectomy: a consecutive, single-centre case series with exclusive use over a 4-year period

Ng,

Masalkhi,

Steel

et al. 2023

BMC Ophthalmol

View full text Add to dashboard Cite

Background To assess the safety and effectiveness of the exclusive use of 27-gauge instruments for all vitreoretinal diseases requiring vitrectomy. Methods In this retrospective study, 1020 consecutive surgeries were performed on 958 eyes of 848 patients using 27-gauge instruments from March 2017 to June 2021. Patients with a minimum follow-up of 3 months were included. Surgical case-mix, best-corrected visual acuity (BCVA), intraocular pressure (IOP), intra- and post-operative complications, and surgery times were recorded. Results The study patients were followed up for averagely 11 months. Of the 1020 vitrectomies, 958 were primary procedures. Of the 148 retinal detachment (RD) cases, 138 (93%) required a single vitrectomy. Primary macular hole closure was achieved in 143 of 145 (99%) cases. The average surgical times were 55 and 38 min for RD surgeries and for all other indications, respectively. BCVA improved significantly at the final visit (20/49) compared with the pre-operative visit (20/78) (p < 0.01). IOP was similar at the pre-operative (14.8mmHg) and final (14.3mmHg) visits. Complications recorded include transient hypotony in 39 eyes, iatrogenic retinal breaks in 2 eyes, and a vitreous bleed in 1 other eye. Conclusion This study revealed that 27-gauge vitrectomy instruments can be used for a wide range of indications, with exclusive use in certain settings. The outcomes were similar to other gauges, including for rhegmatogenous retinal detachment, with minimal complications.

show abstract

Section: Discussionmentioning

confidence: 99%

Twenty-seven-gauge vitrectomy: a consecutive, single-centre case series with exclusive use over a 4-year period

Ng,

Masalkhi,

Steel

et al. 2023

BMC Ophthalmol

View full text Add to dashboard Cite

show abstract

“…Surgeries performed with smaller incisions are associated with reduced scarring, increased accuracy, and lower risks of encountering intra-and post-operative complications [1,2,5]. The advantages and disadvantages of transitioning from 23-gauge to 25-gauge instruments are ampli ed with a progression from 25-gauge to 27-gauge instruments [12,13]. The small distance from the vitrector tip to the port facilitates aspiration of membranes ( brovascular membranes for diabetic delaminations, epiretinal and PVR membranes after starting posteriorly with forceps) and retina during retinectomies.…”

Section: Discussionmentioning

confidence: 99%

Twenty-seven-gauge vitrectomy: A consecutive, single-centre case series with exclusive use over a 4-year period.

Ng,

Masalkhi,

Steel

et al. 2023

Preprint

View full text Add to dashboard Cite

Background: To assess the safety and effectiveness of the exclusive use of 27-gauge instruments for all vitreoretinal diseases requiring vitrectomy. Methods: In this retrospective study, 1020 consecutive surgeries were performed on 958 eyes of 848 patients using 27-gauge instruments from March 2017 to June 2021. Patients with a minimum follow-up of 3 months were included. Surgical case-mix, best-corrected visual acuity (BCVA), intraocular pressure (IOP), intra- and post-operative complications, and surgery times were recorded. Results: The study patients were followed up for averagely 11 months. Of the 1020 vitrectomies, 958 were primary procedures. Of the 148 retinal detachment (RD) cases, 138 (93%) required a single vitrectomy. Primary macular hole closure was achieved in 143 of 145 (99%) cases. The average surgical times were 55 and 38 minutes for RD surgeries and for all other indications, respectively. BCVA improved significantly at the final visit (20/49) compared with the pre-operative visit (20/78) (p<0.01). IOP was similar at the pre-operative (14.8mmHg) and final (14.3mmHg) visits. Complications recorded include transient hypotony in 39 eyes, iatrogenic retinal breaks in 2 eyes, and a vitreous bleed in 1 other eye. Conclusion: This study revealed that 27-gauge vitrectomy instruments can be used for a wide range of indications, with exclusive use in certain settings. The outcomes were similar to other gauges, including for rhegmatogenous retinal detachment, with minimal complications.

show abstract

“…Microincision vitrectomy surgery has many advantages, such as short operation time [2] , low inflammation of the anterior and posterior segments of the eye after surgery [3] , no conjunctival cicatrix after surgery [4][5] , and reduced dry eyes after surgery [6] , which improve the comfort of patients after surgery. However, various complications follow, such as bleeding from the incision, hyperplasia of incision tissue, and vitreoretinal traction [7][8][9] . Moreover, leaking sclerotomy is prone to postoperative hypotony, and sclera-free closure also leads to a higher risk of endophthalmitis after microincision vitrectomy surgery than traditional vitrectomy [10] .…”

Section: Introductionmentioning

confidence: 99%

A sutureless technique for securing leaking sclerotomies with viscoelastic substances in 23-gauge microincision vitrectomy surgery

Li¹,

Mao²,

Liao³

et al. 2023

Int J Ophthalmol

View full text Add to dashboard Cite

AIM: To introduce and evaluate the clinical efficacy of a new technique, the use of viscoelastic substances (VS) to close leaking sclerotomy in 23G microincision vitrectomy, and to observe its effect on the visual acuity and intraocular pressure (IOP) of patients. METHODS: Patients who underwent 23G vitrectomy in Ningbo Eye Hospital before the use of VS technique (June 2019 to September 2020) and after the use of VS technique (October 2020 to December 2021) were selected as the subjects of this study. The above cases underwent operation by the same surgeon and were retrospectively analyzed. VS technique was used as the alternative to suturing, in which a small amount of VS was injected at the leaking sclerotomy and then gently massaged to confirm leaking sclerotomy closure. RESULTS: A total of 174 eyes were covered in the study, including 84 eyes in the control group (before the use of VS technique) and 90 eyes in the VS technique group. The number of eyes that needed to be sutured decreased considerably from 42.9% in the control group to 3.3% in the VS technique group, and the proportion of subconjunctival hemorrhage at 1-2d after surgery decreased remarkably from 35.7% in the control group to 2.2% in the VS technique group. No substantial differences in the incidence of mean IOP and low IOP were found between 1-2 and 3-20d after surgery in the VS technique group. No major complications associated with VS technique were identified during the study. CONCLUSION: In 23G microincision vitrectomy, VS technique is a safe, simple, and effective method to close leaking sclerotomy.

show abstract

Mechanical Property Comparison of 23-, 25-, and 27-Gauge Vitrectors across Vitrectomy Systems

Cited by 4 publications

References 22 publications

Twenty-seven-gauge vitrectomy: a consecutive, single-centre case series with exclusive use over a 4-year period

Twenty-seven-gauge vitrectomy: a consecutive, single-centre case series with exclusive use over a 4-year period

Twenty-seven-gauge vitrectomy: A consecutive, single-centre case series with exclusive use over a 4-year period.

A sutureless technique for securing leaking sclerotomies with viscoelastic substances in 23-gauge microincision vitrectomy surgery

Contact Info

Product

Resources

About