Postoperative Complication Rates in 23- vs 25-Gauge Pars Plana Vitrectomy

Abstract

The purpose of this study was to compare rates of clinically significant complications between 23-and 25-gauge pars plana vitrectomy (PPV) in vitreoretinal surgery. Methods: Demographics, PPV indication, and surgical complications were reviewed. Patients with prior PPV or other retina surgery; cases requiring silicone oil removal, keratoplasty, or glaucoma valve implant; patients <18 years old; or patients with <4 months of follow-up were excluded. Comparative and descriptive statistics were used to evaluate the data. Results: A total of 579 eyes met inclusion criteria, and their charts were reviewed. Demographics, PPV indication, follow-up time, and lens status were similar (P > .05). A 23-gauge PPV was performed more frequently than a 25-gauge PPV (328 vs 251 eyes, respectively). Although rates of eyes with a clinically significant postoperative complication requiring surgical intervention were higher in 23-gauge PPV (112/325, 34.4%) than in 25-gauge PPV (54/250, 21.6%), PPVs indicated by rhegmatogenous retinal detachment were more common with 23-gauge PPVs (155/325, 47.7%) than with 25-gauge PPVs (37/250, 14.8%; P <.001) and were more likely to have postoperative complications; however, rates of recurrent retinal detachments were not different in the 2 cohorts (P ¼ .862). When controlling for differences in indication, there was a moderately higher rate of postoperative complications following 23-gauge PPV (P ¼ .063). Conclusions: This retrospective review suggests that clinically significant complications are moderately more likely following 23-gauge PPV compared with 25-gauge PPV, even when the differences in surgical indication are considered.

Comparison of safety and effectiveness between 23-gauge and 25-gauge vitrectomy surgery in common vitreoretinal diseases

“…Byeon et al followed eyes after 25-gauge vitrectomy and observed retinal detachments in 6% of cases [ 20 ]. A large retrospective chart review of 579 eyes that underwent vitrectomy for different indications showed a retinal detachment rate of 8.2% in the 23-gauge and 4.2% rate in the 25-gauge group [ 21 ]. In a study of 92 patients conducted by Gupta et.…”

Treatment-Emergent Adverse Events in Gene Therapy Trials for Inherited Retinal Diseases: A Narrative Review

“…There are conflicting reports on the rate of intraoperative and postoperative complications among the three main MIVS gauge systems, with most data showing similar safety profiles [ 13 , 14 ]. A recent comprehensive review comparing 23- and 25-gauge pars plana vitrectomy (PPV) surgery showed an increased rate of overall adverse events for the 23-gauge system [ 15 ]. Additionally, 25- and 27-gauge PPV have shown increased intraocular pressure (IOP) stability and decreased conjunctival trauma compared to 23-gauge PPV [ 16 , 17 ].…”