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Small-gauge vitrectomy yields fewer peripheral retinal breaks than standard method
Retina. 2011;31(10):1997-2001.
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Small-gauge vitrectomy resulted in a lower incidence of iatrogenic retinal breaks than the standard procedure, particularly in eyes with macular holes, a study found.
"Lower cutter efficiency and the use of trocars may play important roles to diminish the incidence of retinal breaks in 23-gauge vitrectomy," the study authors said. "The low incidence of iatrogenic retinal breaks in 23-gauge vitrectomy reported in this study may accelerate the use of small-gauge vitrectomy."
The retrospective study included 176 eyes that underwent 23-gauge vitrectomy and 153 eyes that underwent 20-gauge vitrectomy for idiopathic macular holes or idiopathic epiretinal membranes.
Patients with secondary macular holes, pre-existing retinal breaks and/or retinal detachment, history of vitrectomy or postoperative follow-up less than 2 months were excluded.
Mean follow-up was 16.9 months in the 20-gauge vitrectomy group and 8.8 months in the 23-gauge vitrectomy group. Primary outcome measures were the incidence rates of iatrogenic peripheral retinal breaks identified during and after surgery.
Study results showed iatrogenic retinal breaks in one eye during surgery and one eye postoperatively in the 23-gauge group. No sclerotomy-related retinal breaks were identified in this group.
Iatrogenic peripheral retinal breaks were identified in 11 eyes during surgery and two eyes after surgery in the 20-gauge vitrectomy. Sclerotomy-related breaks were identified in six of the 13 eyes.
The 23-gauge vitrectomy group had a statistically lower incidence of iatrogenic peripheral retinal breaks than the 20-gauge vitrectomy group (1.1% vs. 8.5%, P = .0023, the authors said.