Retrospective Comparison of 27-Gauge and 25-Gauge Microincision Vitrectomy Surgery with Silicone Oil for the Treatment of Primary Rhegmatogenous Retinal Detachment

Abstract

Aim To retrospectively compare the safety and effectiveness of 27-gauge (27G) microincision vitrectomy surgery (MIVS) with 25-guage (25G) MIVS for the treatment of primary rhegmatogenous retinal detachment (RRD) with silicone oil tamponade. Methods Ninety-two patients with RRD who underwent MIVS from May 1, 2015, to June 30, 2017, were included in this study. Fifty-eight eyes underwent 25G MIVS and 34 eyes underwent 27G MIVS. We analyzed the characteristics of the patients, surgical time, main clinical outcomes, and rate of complications. Results The mean surgical time was 56.7 ± 35.9 min for the 25G MIVS and 55.7 ± 36.1 min for the 27G MIVS, and there was no significant difference (P=0.894) between the two groups. The primary anatomical success rate after a single operation was 94.8% for 25G MIVS and 91.2% for 27G MIVS (P=0.666). Baseline and final visit best-corrected visual acuity (BCVA) were 1.9 ± 1.1 and 1.0 ± 0.8 in the 25G group, and 1.7 ± 1.0 and 1.1 ± 0.8 in the 27G group. Last visit BCVA increased significantly in both groups (P < 0.001). However, there were no significant differences in terms of visual improvement ratio (>0.2 logMAR) between the two groups (P=0.173). No severe intraoperative complication was observed. Iatrogenic retinal breaks occurred in 2 eyes (3.4%) in the 25G group and 1 eye (2.9%) in the 27G group during the peripheral vitreous base shaving. The transient ocular hypertension (>25 mmHg) within postoperative week 1 was 25.9% in the 25G group and 11.8% in the 27G group (P=0.120). Conclusions This study found no significant anatomical or functional difference between 27G and 25G MIVS in the treatment of primary RRD. Therefore, 27G vitrectomy appears to be a safe and effective surgery for the treatment of primary RRD.

Comparison of 27-Gauge and 25-Gauge Microincision Vitrectomy Surgery for the Treatment of Vitreoretinal Disease: A Systematic Review and Meta-Analysis

“…Seven studies [ 15 , 21 – 24 , 26 , 31 ] were designed as prospective randomized/nonrandomized comparative study and four studies [ 17 , 25 , 29 , 30 ] were retrospective randomized/nonrandomized comparative study. Five trials [ 15 , 17 , 21 , 24 , 29 ] enrolled 554 eyes which were conducted on ERM and six studies [ 22 , 23 , 25 , 26 , 30 , 31 ] enrolled 386 eyes which were conducted on RRD. In total, 940 eyes were included in this meta-analysis; 439 eyes were assigned to the 27-G vitrectomy group and 501 eyes to the 25-G group.…”

“…ese studies were published between 2015 and 2019. Seven studies [15, 21-24, 26, 31] were designed as prospective randomized/ nonrandomized comparative study and four studies [17,25,29,30] were retrospective randomized/nonrandomized comparative study. Five trials [15,17,21,24,29] enrolled 554 eyes which were conducted on ERM and six studies [22,23,25,26,30,31] enrolled 386 eyes which were conducted on RRD.…”

Comparison of 27-gauge and 25-gauge vitrectomy in the management of tractional retinal detachment secondary to proliferative diabetic retinopathy

“…This shortens the time for membrane removal. A recently published study [ 12 , 20 , 21 ] also showed that there was no difference in operation time for vitrectomy between 27-gauge and 25-gauge vitrectomy systems in the management of RRD. Eyes with RRD, as eyes in PDR with TRD, have a more liquefied vitreous.…”

25 vs. 27-gauge micro-incision vitrectomy surgery for visually significant macular membranes and full-thickness macular holes: a retrospective study

“…International Journal of Retina and Vitreous 27G instrumentation has been utilized is increasing, with many surgeons using 27G for macular epiretinal membrane (ERM) peels and full thickness macular holes (FTMH), as well as more complex cases such as proliferative vitreoretinopathy and retinal detachment repairs [15,16]. Several prior studies have compared 27G with other MIVS systems for various indications and they generally suggest that key outcomes between 25-gauge (25G) and 27G are comparable [17][18][19][20][21]. However, it is worth noting that most of these studies have relatively small sample sizes and the majority have been conducted in patient populations in Europe or East Asia.…”

“…Several prior studies have compared 27G with other MIVS systems for various indications and they generally suggest that key outcomes between 25-gauge (25G) and 27G are comparable [ 17 – 21 ]. However, it is worth noting that most of these studies have relatively small sample sizes and the majority have been conducted in patient populations in Europe or East Asia.…”