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Study: New PPV system has good short-term visual outcomes, few complications

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A new single-step 23-gauge pars plana vitrectomy system with a trocar and cannula design appears safe and provides similar visual outcomes to the 20-gauge system, a retrospective, multicenter study suggests. Postoperative hypotony was the most common complication, but all cases were resolved at 1 week postop, the authors noted.

Omesh P. Gupta, MD, MBA, and colleagues evaluated visual acuity, IOP, and intraoperative and postoperative complications after performing primary 23-gauge PPV on 92 patients for a variety of indications.

After an average follow-up of 12 weeks, overall visual acuity had improved from 20/238 at baseline to 20/82 (P < .001), the authors reported.

"Each surgical indication experienced a statistically significant [visual acuity] improvement," the study authors said.

Intraoperative complications included retinal tears in two eyes (2.2%) that necessitated endolaser photocoagulation; two eyes (2.2%) required intraoperative sclerotomy sutures.

Postoperative complications included hypotony in six eyes (6.5%), a retinal tear in one eye (1.1%) and a recurrent retinal detachment in one eye (1.1%); no cases of endophthalmitis were reported.

"Further studies comparing 20-gauge, 23-gauge and 25-gauge systems will more accurately identify the relative potential advantages and disadvantages of each system," the authors said in the August issue of American Journal of Ophthalmology.