Comparison of 27-Gauge and 25-Gauge Microincision Vitrectomy Surgery for the Treatment of Vitreoretinal Disease: A Systematic Review and Meta-Analysis

Ma, Jie; Wang, Qing; Niu, Haoyu

doi:10.1155/2020/6149692

Cited by 18 publications

(29 citation statements)

References 32 publications

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“…This was suggested also in a previous similar meta‐analysis study which showed similar promising outcomes for 27‐gauge microincision vitrectomy surgery in improving the best corrected visual acuity and reducing the wound closure time. 42 Well‐conducted randomised controlled trials are needed to assess these factors and the combination of different gender, ages, ethnicity, and other variants of subjects; since our meta‐analysis study could not answer whether different ages and ethnicity are related to the results.…”

Section: Discussionmentioning

confidence: 97%

27‐gauge microincision vitrectomy surgery compared with 25‐gauge microincision vitrectomy surgery on wound closure and need for wound suture and other postoperative parameters in the treatment of vitreoretinal disease: A meta‐analysis

Wei

et al. 2022

International Wound Journal

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We performed a meta-analysis to evaluate the effect of 27-gauge microincision vitrectomy surgery compared with 25-gauge microincision vitrectomy surgery on wound closure and the need for wound suture and other postoperative parameters in the treatment of vitreoretinal disease. A systematic literature search up to June 2022 was performed and 1264 subjects with the vitreoretinal disease at the baseline of the studies; 562 of them were using the 27-gauge microincision vitrectomy surgery, and 722 were using 25-gauge microincision vitrectomy surgery. Odds ratio (OR), and mean difference (MD) with 95% confidence intervals (CIs) were calculated to assess the effect of 27-gauge microincision vitrectomy surgery compared with 25-gauge microincision vitrectomy surgery on wound closure and the need for wound suture and other postoperative parameters in the treatment of vitreoretinal disease using the dichotomous, and contentious methods with a random or fixed-effect model. The 27-gauge microincision vitrectomy surgery subjects had a significantly lower intraoperative and postoperative wound complication (OR, 6.66; 95% CI, 0.46-0.95, P = .02), and wound suture number (OR, 0.38; 95% CI, 0.20-0.71, P = .002), and best corrected visual acuity (MD, À0.03; 95% CI, À0.05 to À0.001, P = .02) compared with 25-gauge microincision vitrectomy surgery in subjects with vitreoretinal disease. However, 27-gauge microincision vitrectomy surgery subjects had no significant difference in the wound closure time (MD, À8.45; 95% CI, À23.44 to 6.55, P = .27), operation time (MD, 0.85; 95% CI, À1.17 to 2.86, P = .41), intraocular pressure at postoperative day 1 (MD, 0.42; 95% CI, À1.45-2.28, P = .66), primary anatomical success rate (OR, 0.83; 95% CI, 0.42-1.63, Siying Li and Yichun Li contributed equally to this work and should be considered coauthors.

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Section: Discussionmentioning

confidence: 97%

27‐gauge microincision vitrectomy surgery compared with 25‐gauge microincision vitrectomy surgery on wound closure and need for wound suture and other postoperative parameters in the treatment of vitreoretinal disease: A meta‐analysis

Wei

et al. 2022

International Wound Journal

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“…One meta-analysis of 940 eyes showed the mean operation time was significantly longer by 3 minutes for 27-G compared with 25-G vitrectomy. 13 As the instrument gauge decreases, more time may be needed for vitreous dissection. 14 In our study, average surgical time for pediatric cases was 53 minutes with a range of 20 minutes for cataract surgeries to 119 minutes for retinal detachments.…”

Section: Discussionmentioning

confidence: 99%

27-Gauge Pars Plana/Plicata Vitrectomy for Pediatric Vitreoretinal Surgery

Ung¹,

Yonekawa

Chung

et al. 2023

Retina

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Purpose: To report on the feasibility of 27-gauge (G) vitrectomy for pediatric patients. Methods: This study is an international, multicenter, retrospective, interventional case series. Participants were patients 17 years or younger who underwent 27-G vitrectomy for various indications.Results: The records of 56 eyes from 47 patients were reviewed. Mean age was 5.7 6 5.2 years. Diagnoses included retinopathy of prematurity (Stages 3 with vitreous hemorrhage, 4A, 4B, and 5), Terson's syndrome, traumatic macular hole, posterior capsular opacification, endophthalmitis, and others. Instruments used were the 27-G infusion, 27-G vitreous cutter, 27-G light pipe, and 27-G internal limiting membrane forceps. Instrument bending was noted in one (1.8%) case. There were no cases with intraoperative complications, infusion issues, or postoperative endophthalmitis. There were 67/145 (46%) sclerotomies that required suturing, of which most (51/145) were sutured out of precaution. There were four cases (7.1%) that required conversion to a larger gauge and three cases (5.3%) that developed postoperative hypotony. Mean visual acuity improved from logarithm of the minimum angle of resolution 1.32 (20/420) to 0.72 (20/105), after a mean follow-up of 125.1 days (P = 0.01). Anatomic success was achieved in 96.4% of eyes after a single surgery.Conclusion: Twenty-seven-gauge vitrectomy was safe and feasible in selected pediatric vitreoretinopathies. Further studies are warranted to examine indications and outcomes.

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“…The gold standard of therapy for symptomatic ERM is a pars-plana vitrectomy with membranectomy and peeling of the inner limiting membrane (ILM peeling) [ 12 , 13 ]. However, this usually leads to cataract development in phakic eyes.…”

Section: Introductionmentioning

confidence: 99%

Influence of Preoperative Foveal Layers’ Thickness on Visual Function and Macular Morphology by Phacovitrectomy for Epiretinal Membrane

Zhmurin

Grajewski

Krause

2022

Journal of Ophthalmology

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Background. The aim of this retrospective study with short, differently dispersed follow-up is to record the relationships between the pathologies of the individual foveal layers, measured by spectral domain optical coherence tomography (SD-OCT), and to investigate their influence on pre- and postoperative best-corrected decimal far visual acuity (BCVA) by phacovitrectomy for epiretinal membrane (ERM) in comorbidity with cataract. Patients and Methods. 208 eyes of 173 patients with symptomatic idiopathic ERM and moderate cataract were included. Results. In all OCT morphological stages of ERM, as well as in their combination with macular lamellar hole (MLH) and vitreomacular traction (VMT), a significant difference in the thickness of the individual fovea layers was found. In addition, the entire fovea thickening led to the proportional thickening of the individual fovea layers ( p < 0.001 ). The larger the central foveolar (CFT, R2 = −0.238, p = 0.002 ), maximum foveal (MFT, R2 = −0.267, p = 0.001 ), and ONL thickness (R2 = −0.16, p = 0.044 ) were preoperatively, the worse the initial visual acuity was at all OCT stages of ERM. This was even more significant in the presence of a tractive component in the case of MLH or VMT ( p < 0.001 ). In ERM without a traction component, only ONL thickening led to significant postoperative visual acuity reduction (R2 = −0.163, p = 0.047 ). The foveolar retinal thickening (CFT and MFT) of the pure ERM is directly associated with distortion of the retinal layers (R2 = 0.292, p < 0.001 and R2 = 0.287, p < 0.001 ) as well as with separation of the ERM (R2 = 0.168, p = 0.034 and R2 = 0.187, p = 0.018 ). When ERM was combined with tractive component, CFT, ONL, and INL thickness correlated (positively) with the integrity of ellipsoid zone (R2 = 0.342, p < 0.05 ) and external limiting membrane (R2 = 0.548, p < 0.001 ). Conclusions. ONL thickening in ERM without a tractive component serves as a limited prognostic factor of postoperative visual acuity decrease. The preoperative BCVA in the groups of ERM with traction component showed significant correlation with CFT as well as with the thickness of individual foveal layers. VMT in ERM correlates with the disintegration of the ellipsoid zone.

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Comparison of 27-Gauge and 25-Gauge Microincision Vitrectomy Surgery for the Treatment of Vitreoretinal Disease: A Systematic Review and Meta-Analysis

Cited by 18 publications

References 32 publications

27‐gauge microincision vitrectomy surgery compared with 25‐gauge microincision vitrectomy surgery on wound closure and need for wound suture and other postoperative parameters in the treatment of vitreoretinal disease: A meta‐analysis

27‐gauge microincision vitrectomy surgery compared with 25‐gauge microincision vitrectomy surgery on wound closure and need for wound suture and other postoperative parameters in the treatment of vitreoretinal disease: A meta‐analysis

27-Gauge Pars Plana/Plicata Vitrectomy for Pediatric Vitreoretinal Surgery

Influence of Preoperative Foveal Layers’ Thickness on Visual Function and Macular Morphology by Phacovitrectomy for Epiretinal Membrane

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