Endophthalmitis After 25-Gauge and 20-Gauge Pars Plana Vitrectomy

Abstract

Clinician grading of retinopathy severity had moderate agreement with RC grading and might be useful for placing eyes into broad baseline categories.

The incidence of endophthalmitis following transconjunctival sutureless 25- vs 20-gauge vitrectomy

“…The incidence of endophthalmitis (1.6%) was eight times higher than what Kunimoto and Kaiser 18 and the current study reported in 25-gauge vitrectomy and two times larger than what Scott reported. 15 However, Shaikh's study population was small and not powered to detect a true difference in endophthalmitis rates following the two surgical techniques.…”

“…In another study, Scott et al 15 recently retrospectively examined 6375 patients who underwent 20-gauge PPV and 1307 patients who underwent 25-gauge PPV. The incidence of endophthalmitis was 0.03% for 20-gauge PPV compared to 0.84% for 25-gauge PPV (Po0.0001), which represents a 24 times increased risk with the sutureless 25-gauge system.…”

“…There have been several reports of endophthalmitis following 25-gauge transconjunctival sutureless vitrectomy. 11,[13][14][15] In addition, the first systematic study to document the incidence of endophthalmitis following 25-gauge vitrectomy was recently published. Kunimoto and Kaiser 18 retrospectively analysed 8601 consecutive cases of vitrectomy and found that 25-gauge vitrectomy had a statistically significant 12-fold higher incidence of endophthalmitis (culture results not recorded) compared with 20-gauge vitrectomy (0.23 vs 0.018%, P ¼ 0.004).…”

“…[2][3][4][5][6][7] Reported complications include retinal break, retinal detachment, macular hole, cataract progression, hypotony, and breakage of the 25-gauge cutter within the eye. 2,[8][9][10] More concerning, several reports have suggested that the 25-gauge system may result in an increased incidence of postoperative endophthalmitis, [11][12][13][14][15] which can lead to significant morbidity as potential sequelae include irreversible loss of vision. The purpose of this study was to estimate the incidence of endophthalmitis after sutureless 25-gauge vitrectomy surgery and to determine whether there was an increased risk of infection after 25-gauge vitrectomy compared to traditional 20-gauge vitrectomy.…”

25th RCOphth Congress, President's Session paper: 25 years of progress in vitreoretinal surgery

“…34 Similar results were reported from the Bascom Palmer Eye Institute with a rate in 25-gauge patients of (0.84% 11/1307 eyes) compared with 20-gauge vitrectomy (0.03%; 2/6375). 35 Since these 36 The surgeons in this latter study emphasised the importance of conjunctival irrigation, ensuring sclerotomy closure and removal of peripheral vitreous as important preventative measures. Another potential problem is hypotony that is directly related to leaking wounds.…”