Postop endophthalmitis rate comparable for 20- and 25-gauge pars plana vitrectomy

Ophthalmology. 2009;116(7):1360-1365.

The incidence of postoperative endophthalmitis was similar after sutured 20-gauge pars plana vitrectomy and sutureless 25-gauge pars plana vitrectomy, according to a large study.

"The incidence of endophthalmitis was low in both groups," the study authors said. "We ... conclude that a careful perioperative anti-infection protocol may reduce 25-gauge [pars plana vitrectomy, PPV] endophthalmitis risk to that of 20-gauge PPV."

The retrospective, comparative case series included 1,948 cases of 20-gauge PPV and 1,424 cases of 25-gauge PPV. Average patient age was 54.6 years in the 20-gauge PPV group and 64.4 years in the 25-gauge PPV group.

The 20-gauge group had three sutured 20-gauge sclerotomies, and the 25-gauge group had one or more unsutured sclerotomies. Clinical criteria excluding microbiological findings were used to identify endophthalmitis.

Mean post-PPV follow-up was 12.5 months in the 20-gauge PPV group and 13 months in the 25-gauge PPV group.

Endophthalmitis was found in one patient in the 25-gauge PPV group and in no patients in the 20-gauge PPV group. Use of air/gas endotamponade and intravitreal triamcinolone was more common in the 25-gauge PPV group than in the 20-gauge group, the authors said.