Comparison of Clinical Outcomes and Wound Dynamics of Sclerotomy Ports of 20, 25, and 23 Gauge Vitrectomy

Nagpal, Manish; Wartikar, Sharang; Nagpal, Kamal

doi:10.1097/iae.0b013e3181934908

Cited by 86 publications

(71 citation statements)

References 15 publications

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“…Whereas classical 20G vitrectomy allows vitreous ‘shaving’ at the inner sclerotomy, the removal of the vitreous at the inner sclerotomy site between the 2 mm of the sclerotomy and the end of the cannula with the 23G sutureless system is incomplete. This is supported by an endoscopic analysis of the dynamics of 23G sclerotomy port closure revealing a herniation of vitreous strands into the scleral tunnel [1]. …”

Section: Discussionmentioning

confidence: 94%

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Subclinical Choroidal Detachment at Sclerotomy Sites after 23-Gauge Vitrectomy: Analysis by Anterior Segment Optical Coherence Tomography

Guthoff¹,

Riederle²,

Meinhardt³

et al. 2010

Ophthalmologica

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Purpose: Transient ocular hypotony commonly occurs after 23-gauge (23G) vitrectomy. To assess possible causes, we visualized the sclerotomy site and pars plana by anterior segment optical coherence tomography (AS-OCT). Procedures: We prospectively analyzed the intraocular pressure (IOP) and findings related to clinical hypotony, assessed by AS-OCT, in 13 consecutive eyes of 13 patients receiving 23G vitrectomy. Five patients receiving a 20G vitrectomy served as controls. Results: The mean IOP after 23G vitrectomy was 11 mm Hg (range: 5–32 mm Hg; 13 eyes) at postoperative day 1. In contrast to controls, AS-OCT showed a scleral gap at the incision site in 22/39 sclerotomies (10/13 eyes), and subclinical choroidal detachment in 9/13 eyes. Conclusions: A scleral gap and choroidal detachment at the incision site are frequent findings following 23G vitrectomy. These subclinical features may account for postoperative hypotony as they are absent in 20G vitrectomy and scleral sutures. Hypotony following 23G vitrectomy is a self-limiting phenomenon and usually does not require therapeutic intervention.

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Section: Discussionmentioning

confidence: 94%

“…Transconjunctival sutureless vitrectomy provides several advantages over traditional 20-gauge (20G) vitrectomy, including faster wound healing, less conjunctival scarring, improved patient comfort, decreased inflammation, reduced surgically induced astigmatism and a shortening of surgical opening and closing times [1]. …”

Section: Introductionmentioning

confidence: 99%

Subclinical Choroidal Detachment at Sclerotomy Sites after 23-Gauge Vitrectomy: Analysis by Anterior Segment Optical Coherence Tomography

Guthoff¹,

Riederle²,

Meinhardt³

et al. 2010

Ophthalmologica

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“…Comparison between 20G and 25G vitrectomy revealed that the time saved was localized to the 'initial' and 'final' steps of the procedure (13). Damage to the conjunctiva was also minimalized with a transconjunctival, sutureless approach (14). This may be of clinical significance in patients requiring glaucoma filtration surgery in the future.…”

Section: Introductionmentioning

confidence: 91%

25G compared with 20G vitrectomy under Resight non-contact wide-angle lenses for Terson syndrome

Mao

You

2017

Experimental and Therapeutic Medicine

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Abstract. The aim of the present study was to compare the effectiveness of 25G vitrectomy to standard 20G vitrectomy for treatment of Terson syndrome under Resight non-contact wide-angle lenses. This was a case-control study of 20 patients with Terson syndrome (study group) that underwent 25G vitrectomy under Resight non-contact wide-angle lenses, with those of 20 matched patients that underwent 20G vitrectomy (control group). Medical records were reviewed from between July 2011 and October 2013. Data included results of the Early Treatment Diabetic Retinopathy Study examination, ophthalmology B-scan ultrasonography and fundus photography. The mean age, follow-up time, the preoperative visual acuity of LogMAR and the preoperative intraocular pressure (IOP) were all comparable in the two groups (all P>0.05). There were statistically significant differences in postoperative visual acuity of LogMAR compared with preoperative visual acuity (P<0.001) in both groups, but no difference between the groups (P=0.845). However, the operative times (13.5 min in study group vs. 42 min in control group) and post-operative IOP at day 1 (13.5 vs. 20 mmHg) were significantly reduced in the study group compared to the control group (P<0.001). Therefore, the present findings suggest that 25G Vitrectomy for Terson syndrome under Resight non-contact wide-angle lenses can achieve a significantly shorter operative time and lower post-operative IOP compared with 20G Vitrectomy.

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“…Though post-operative RD subsequent to microincision sutureless PPV has been reported in several studies, 83 the investigators concluded that development of RD did not directly result from the microincision 23G or 25G technique. 69 In a study, Ibarra et al reported a RD incidence of 2.2 % after macular hole repair.…”

Section: Retinal Detachmentmentioning

confidence: 99%

Micro-incision Vitrectomy Surgery – Past, Present and Future

Nagpal¹,

Verma²,

Goswami³

2015

European Ophthalmic Review

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The advent of micro-incision vitrectomy surgery (MIVS) changed the approach, indications and complications of vitreoretinal surgeries forever. Since its introduction in 2002, MIVS has been gaining popularity amongst retinal surgeons for managing a wide variety of vitreoretinal disorders. MIVS allows for more efficient surgery, faster recovery time and better visual outcomes than 20G vitrectomy. The use of instrumentation having small diameters reduced trauma from conjunctival and scleral manipulation as well as post-operative inflammation and corneal astigmatism. Further refinement of techniques with the introduction of 27G for routine procedures increases the comfort for the patient and minimises the recovery time. In this review, we briefly summarise the journey of MIVS to its present status and discuss the various advances that have taken place to achieve better efficiency and results.

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Comparison of Clinical Outcomes and Wound Dynamics of Sclerotomy Ports of 20, 25, and 23 Gauge Vitrectomy

Abstract: The small gauge systems are safe and equally effective than the 20-G system for non-complicated vitreous hemorrhage cases with faster recovery and more comfort for the patient. Increased vitreous clogging with small gauge systems does not extrapolate to an increased risk of complications.

Cited by 86 publications

References 15 publications

Subclinical Choroidal Detachment at Sclerotomy Sites after 23-Gauge Vitrectomy: Analysis by Anterior Segment Optical Coherence Tomography

Subclinical Choroidal Detachment at Sclerotomy Sites after 23-Gauge Vitrectomy: Analysis by Anterior Segment Optical Coherence Tomography

25G compared with 20G vitrectomy under Resight non-contact wide-angle lenses for Terson syndrome

Micro-incision Vitrectomy Surgery – Past, Present and Future

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