Surgical outcomes of 27-gauge and 25-gauge vitrectomy day surgery for proliferative diabetic retinopathy

Naruse, Zeon; Shimada, Hiroyuki; Mori, Ryusaburo

doi:10.1007/s10792-018-1030-z

Cited by 18 publications

(20 citation statements)

References 36 publications

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“…In this comparative study, we noted that the operation time is similar in both groups, if not shorter in the 27-gauge group, which is different from previous reports in which more time is needed in the 27-gauge vitrectomy system in the management epiretinal membrane and PDR [10][11][12]. The difference from previous reports may lie in the fact that eyes with PDR and TRD generally have more liquefied vitreous, thus, the difference of the surgical time for removing the core vitreous between these two systems is less.…”

Section: Plos Onecontrasting

confidence: 88%

“…Post-operative outcomes measures included the improvement of BCVA, ocular hypotony, ocular hypertension, the presence of recurrent vitreous haemorrhage (VH), re-operation rates, and time to develop cataract. Ocular hypotony is defined as an IOP of 6 mmHg or lower, and ocular hypertension is defined as an IOP of 25 mmHg or higher [12]. VH recurred at 1 month or longer after the surgery was recorded as recurrent haemorrhage [14].…”

Section: Methodsmentioning

confidence: 99%

“…Since the introduction of a 27-gauge vitrectomy system, there have been several studies comparing the 27-gauge and 25-gauge system in the management of retinal diseases, including rhegmatogenous retinal detachment (RRD), epiretinal membrane and proliferative diabetic retinopathy (PDR) [10][11][12][13]. In this retrospective study, we aim to compare the difference between the 27 and 25-gauge system in the management of tractional retinal detachment (TRD) secondary to PDR, to see whether the 27-gauge vitrectomy system offers advantages over the 25-gauge system in complicated retinal disease…”

Section: Introductionmentioning

confidence: 99%

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

Chen

2021

PLoS ONE

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Objective To compare surgical outcomes between 27 and 25-gauge vitrectomy in proliferative diabetic retinopathy (PDR) with tractional retinal detachment (TRD) Methods This retrospective study was conducted to compare the intraoperative status, operation time, use of instruments, endotamponade substance, wound suture number, and iatrogenic break, between 27 and 25-gauge vitrectomy in 43 eyes afflicted by PDR with TRD. The post-surgical results, best-corrected visual acuity, intraocular pressure, recurrent vitreous haemorrhage, and re-operation rate were regularly followed up for 6 months. Results Patients in the 25 and the 27-gauge groups did not differ significantly in terms of pre-surgical conditions, such as age, gender, pre-existing glaucoma, best-corrected visual acuity (BCVA) and the severity of their TRD. The mean operation time was 56.7 minutes in the 27-gauge group and 63.7 minutes in the 25-gauge group (p = 0.94). There is significantly less use of micro forceps in the 27-gauge group (p = 0.004). No difference between micro scissors and chandelier usage were noted; neither was their difference in iatrogenic retinal breaks. Significantly fewer wound sutures were noted in the 27-gauge group (p < 0.001). The post-operative results revealed no significant difference in ocular hypertension, hypotony, BCVA improvement, recurrent vitreous haemorrhage and re-operation rate. Conclusions The 27-gauge vitrectomy system offers comparable surgical outcomes in PDR with TRD. The 27-gauge vitrectomy system is suitable for complicated retinal surgery.

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Section: Plos Onecontrasting

confidence: 88%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

Chen

2021

PLoS ONE

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“…Micro-Incision Vitrectomy Surgery (MIVS) offers an excellent safety profile for patients, while the newest 27-gauge (27G) systems have potential additional safety and outcome benefits when compared to earlier MIVS platforms. This innovation towards progressively smaller instrumentation is playing a major role in the evolution of posterior segment surgery by allowing for decreased incision size and, possibly, less pain, [1,2] fewer post-surgical wound leaks and subsequently, faster recovery times [3][4][5] with a low risk of other post-operative complications (6)(7)(8). Specifically, multiple large cohort studies and a 2013 literature review concluded there was no increased risk of endophthalmitis when comparing MIVS to 20-gauge (20G) vitrectomy [9][10][11][12].…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2020

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Background To evaluate visual and safety outcomes for 25-gauge (25G) and 27-gauge (27G) micro-incision vitrectomy platforms (MIVS) for the treatment of epiretinal membrane and full-thickness macular holes. Methods Retrospective analysis of all patients who underwent internal limiting membrane (ILM) peel surgery from January 2017 through December 2018. 207 cases met the eligibility criteria for inclusion. Primary endpoint was post-operative Best-Corrected Distance Visual Acuity (BCVA) at 6 months. Results For all patients combined, mean logMAR BCVA improved from 0.57 (± 0.40) to 0.37 (± 0.36) post-operatively (p < 0.001). For 25G ERMs, logMAR BCVA improved from 0.51 (± 0.28) to 0.30 (± 0.25) post-operatively (p < 0.001). For 27G ERMs, logMAR BCVA improved from 0.33 (± 0.28) to 0.28 (± 0.27) post- operatively (p = 0.15). For 25G FTMHs, logMAR BCVA improved from 0.87 (± 0.48) to 0.51 (± 0.44) post-operatively (p < 0.001). For 27G FTMHs, logMAR BCVA changed from 0.89 (± 0.47) to 0.96 (± 0.60). Conclusion Final visual outcomes improved for both 25G and 27G ERM groups and the 25G FTMH group. Both 25G and 27G were safe and well tolerated MIVS platforms for the treatment of ERM and FTMH.

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“…4 Since the initial report of a 27G transconjunctival sutureless vitrectomy system by Oshima and colleagues, 5 this technique has being widely adopted. While various authors [6][7][8][9] have confirmed its safety and efficacy compared to traditional smallgauge vitrectomy systems, the risk for iatrogenic retinal breaks has not been quantified thus far.…”

Section: Introductionmentioning

confidence: 99%

The Incidence of Retinal Breaks Induced by Posterior Hyaloid Separation During 27-Gauge Pars Plana Vitrectomy

Rahman

Patil

Stephenson

2019

Journal of VitreoRetinal Diseases

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Purpose: As advances are made in smaller-gauge vitrectomy, it is important to characterize the associated risks. This allows the surgeon to anticipate complications and appropriately counsel patients. The incidence of iatrogenic retinal breaks in 25- and 23-gauge (G) vitrectomy is known, but no studies exist looking at the incidence in 27G vitrectomy with an attached posterior hyaloid face (PHF). This study set out to characterize the incidence. Methods: A retrospective, consecutive, observational study of patients undergoing 27G transconjunctival sutureless vitrectomy for macular pathology or floaters was conducted. This was a single-surgeon series conducted between 2015 and 2017 at Calderdale Royal Hospital, United Kingdom. Inclusion criteria included only those with an attached PHF at the disc, identified intraoperatively. Results: Data were collected and analyzed in 94 patients. Preoperative diagnosis frequency was as follows: epiretinal membrane 24 (25.5%), macular hole 47 (50.0%), vitreomacular traction 11 (11.7%), and floaters 12 (12.8%). In 82 out of 94 patients (89.1%), 27G vitrectomy was combined with 2.2 mm microincisional phacoemulsification with lens implantation. The incidence of iatrogenic retinal breaks associated with PHF separation during 27G PPV was 17% (16 cases). Conclusions: This is the first study to report the incidence of peripheral retinal breaks induced by PHF separation during 27G vitrectomy. Our single-surgeon case series of 27G PPV for all elective vitreoretinal indications, in eyes with attached vitreous, yielded an iatrogenic break rate of 17%. However, no postoperative retinal detachments followed. Statistical analysis revealed no specific risk factors to be significantly associated with outcome (incidence of retinal tear).

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Surgical outcomes of 27-gauge and 25-gauge vitrectomy day surgery for proliferative diabetic retinopathy

Cited by 18 publications

References 36 publications

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

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

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

The Incidence of Retinal Breaks Induced by Posterior Hyaloid Separation During 27-Gauge Pars Plana Vitrectomy

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