Transconjunctival 25-Gauge Sutureless Vitrectomy and Silicone Oil Injection in Diabetic Tractional Retinal Detachment

Abstract

Pars plana vitrectomy and 1,000 centistokes silicone oil injection with 25-gauge system is feasible in diabetic tractional retinal detachment even in complex cases. Indications of 25-gauge surgery may be expanded toward this area.

Outcomes of 25-gauge vitrectomy for proliferative diabetic retinopathy

“…This drawback can be avoided by the use of a special 25-G cannula for silicone oil injection, as reported by Altan et al [18] or even by the use of a 24-G angiocatheter with a rigid 25-G stylet needle as reported by Riemann et al [19]. We encountered iatrogenic retinal tears in 31.5% of cases that needed membrane dissection.…”

“…Previous studies that reported the outcomes of 25-G TSV in these conditions included a limited number of cases [3,18,[21][22][23][24]. The purpose of this study is to evaluate the efficacy and safety of 25-G TSV for the management of PDR.…”

“…With the recent development of stiffer 25-G microsurgical instruments, such as forceps, scissors and directional endolaser probes, as well as the development of wide-angle illumination, more patients with complicated conditions, such as rhegmatogenous retinal detachment (RD), proliferative vitreoretinopathy, and diabetic tractional RD, are now being considered for 25-G TSV [18][19][20][21][22][23][24].…”

Surgical outcomes of 25-gauge pars plana vitrectomy for diabetic tractional retinal detachment

“…Most studies were limited in size, retrospective, and utilized primarily silicone oil. 6,7,[17][18][19] However, a prospective, randomized study by Kumar and colleagues compared the visual and anatomic success rates of 23-G versus 25-G PPV with C3F8 or silicone oil tamponade for repair of diabetic TRD (25 eyes in both groups). Complication rates were similar, and anatomic success was achieved in all 50 eyes in the study.…”

“…6 Given the benefits of 25-G systems, several studies have investigated its use in the treatment of complicated retinal detachment, including diabetic TRD; comparable outcomes and complication rates between 25-G PPV and 20-G or 23-G systems have been found. 6,7,[17][18][19][20] However, these studies included limited numbers of TRD eyes and only evaluated silicone oil or octofluoropropane (C3F8) tamponades. This study aims to evaluate the effectiveness of 25-G PPV and a variety of tamponade agents in a large population of eyes with diabetic TRD, many of which also had combined rhegmatogenous retinal detachments (RRD) or PVR.…”