Outcomes of transconjunctival sutureless 27-gauge micro‑incision vitrectomy surgery in diabetic vitreous haemorrhage

Shahzadi, Bashiran; Rizwi, Syed Fawad; Qureshi, Faisal Murtaza; Latif, Kanwal; Mahmood, Syed Asaad

doi:10.12669/pjms.331.11617

Cited by 6 publications

(4 citation statements)

References 11 publications

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“…also showed that 27G vitrectomy was useful in diabetic vitreous hemorrhage. [ 10 ] However, these studies did not evaluate the cases on the basis of anatomical status of retina and did not mention how many of their cases had TRD, secondary RRD, thick FVP, and VPT. We retrospectively evaluated complex diabetic vitrectomy cases only and were able to tackle all these complex situations in a satisfactory way.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of twenty-seven-gauge vitrectomy for complex proliferative diabetic retinopathy

Kumar

Verma

Shiny

et al. 2023

Oman Journal of Ophthalmology

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PURPOSE: To evaluate the outcomes of twenty-seven-gauge (27G) vitrectomy in cases with complex proliferative diabetic retinopathy (PDR). METHODS: This was a retrospective interventional study of eyes that underwent 27G vitrectomy for complex PDR. The demographic profile, history, examination findings, and intraoperative surgical steps (especially use of other instruments such as intravitreal scissors/forceps) were reviewed. All the eyes were followed up for a minimum of 3 months at 1-week, 1-month, and 3-month interval. Visual acuity, intraocular pressure (IOP), and retinal status were documented at every follow-up. RESULTS: Nineteen eyes of 17 patients with complex PDR were included in the study. Seven eyes had tractional retinal detachment involving the macula, three had tractional retinal detachment threatening the macula, one had secondary rhegmatogenous retinal detachment, and eight eyes had nonresolving vitreous hemorrhage along with thick fibrovascular proliferation (FVP) at posterior pole. Anatomical attachment was seen in all cases at the end of follow-up with a single surgery. Visual acuity improved from logMAR 2.5 preoperatively to logMAR 1.01 at 3 months ( P = 0.0003). None of the cases required use of intravitreal scissors/forceps for the removal of FVP. Early postoperative vitreous hemorrhage was seen in two eyes. Hypotony was not seen in any eye, while increased IOP was seen in five eyes. CONCLUSION: 27G vitrectomy is a safe and effective technique in cases with complex diabetic surgery. Due to smaller size cutter, it offers advantages in the dissection of tissue and is associated with lower incidence of early postoperative hemorrhage.

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Section: Discussionmentioning

confidence: 99%

Evaluation of twenty-seven-gauge vitrectomy for complex proliferative diabetic retinopathy

Kumar

Verma

Shiny

et al. 2023

Oman Journal of Ophthalmology

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“…However, the vitrectomy efficiency improved dramatically by changing the drive system of the vitrectomy machine 3,4 and by developing a bi-blade vitreous cutter 5,6 . Although the debate on shaft stiffness is still ongoing, an increasing number of reports have found that these instruments pose no problem in surgical procedures [7][8][9][10][11] . There were concerns about inadequate light intensity with the light pipe, although the light source was changed from halogen to xenon and/or mercury vapor and chandelier lighting has also become commonplace 12,13 , thereby securing sufficient light intensity.…”

Section: Impact Of Different Manufacturers and Gauge Sizes On The Permentioning

confidence: 99%

“…There are virtually no problems now regarding brightness of the surgical field during surgery. Thus, many recent reports have found that 27G vitrectomy is sufficiently practical and useful in the treatment of various vitreoretinal diseases, which was initially regarded as difficult [7][8][9][10][11] .…”

Section: Impact Of Different Manufacturers and Gauge Sizes On The Permentioning

confidence: 99%

Impact of different manufacturers and gauge sizes on the performance of backflush needle

Imai

Tetsumoto

Yamada

et al. 2020

Sci Rep

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The present study aimed to identify the factors regulating aspiration rate (AR) of backflush needles and to compare those factors across various backflush needles from different manufacturers. The 27-gauge (27G), 25-gauge, and 23-gauge backflush needles from four different manufacturers, Alcon, MedOne, VitreQ, and DORC, were used for this experiment. AR was measured at four different aspiration vacuum levels: 100, 200, 400, and 650 mmHg. AR was significantly increased as the aspiration vacuum level increased when both aspirating balanced salt solution (BSS) and ethylene glycol; however, 27G products from VitreQ and MedOne were unable to aspirate ethylene glycol at the low aspiration vacuum level of 100 mmHg. When aspirating BSS at the high aspiration vacuum level of 650 mmHg, a smaller gauge number generally resulted in a significantly higher AR. AR, inner diameter, and cross-sectional area in Alcon products were significantly larger in any gauge, and the shaft length of Alcon products was significantly shorter than those of other manufacturers’ products in any gauge. Cross-sectional area negatively correlated with the degree of shaft deflection (r2 = 0.21, p = 0.042). These results imply that AR differs significantly among backflush needles and among companies depending on the shaft cross-sectional area.

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“…In 2010, Oshima et al ( 7 ) first reported 100% anatomic success and 65% visual improvement of ≥3 lines using a novel 27-gauge (27-G) PPV system in patients with vitreoretinal diseases. Small-gauge vitrectomy has become popular due to its notable advantages, including less trauma, shortened convalescence, reduced inflammatory response and improved manoeuvrability ( 8 ). As a result, the use of 27-G PPV has expanded from simple macular diseases to complicated cases, including rhegmatogenous retinal detachment (RRD) ( 9 ).…”

Section: Introductionmentioning

confidence: 99%

27‑Gauge vitrectomy vs. 25‑gauge vitrectomy in the management of proliferative diabetic retinopathy with preoperative intravitreal injection of conbercept

Xiang,

Fang,

Jiang

et al. 2023

Exp Ther Med

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Small-gauge vitrectomy has become popular due to its notable advantages, including less trauma, shortened convalescence and improved manoeuvrability. The aim of the present study was to compare the surgical outcomes of 27-gauge (27-G) vitrectomy with those of 25-gauge (25-G) vitrectomy in the management of proliferative diabetic retinopathy (PDR) with preoperative intravitreal injection of conbercept. The data of 48 consecutive patients with PDR (48 eyes) were retrospectively collected. The patients underwent conbercept intravitreal injection and pars plana vitrectomy with a 27-G group (23 eyes) or 25-G group (25 eyes) vitrectomy system. The operating time, suturing rate, endodiathermy rate, postoperative best-corrected visual acuity (BCVA), intraocular pressure (IOP) and complications were recorded. The mean postoperative BCVA at final follow-up was significantly improved compared with that at the baseline in both groups (P<0.001 for both). The differences in the mean BCVA changes between the two groups were not significant (P>0.99), and no differences were observed in the final central foveal thickness (P=0.51) between the two groups. The final IOP remained stable compared with that at the baseline in the 27-G group (P=0.36) and the 25-G group (P=0.05). The suturing rate was significantly decreased in the 27-G group compared with the 25-G group (P=0.04). There were no significant differences between the two groups in terms of the operating time (P=0.18), rate of endodiathermy use (P>0.99), iatrogenic retinal breaks (P=0.42) or postoperative recurrent vitreous haemorrhage (P>0.99). In addition, no case of ocular hypotony was observed in either group. In conclusion, 27-G vitrectomy was as efficient and safe as 25-G vitrectomy in the management of PDR in terms of operating time and complications. With reference to the literature, preoperative conbercept injection appears to assist in decreasing the incidence of intraoperative and postoperative complications.

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Outcomes of transconjunctival sutureless 27-gauge micro‑incision vitrectomy surgery in diabetic vitreous haemorrhage

Cited by 6 publications

References 11 publications

Evaluation of twenty-seven-gauge vitrectomy for complex proliferative diabetic retinopathy

Evaluation of twenty-seven-gauge vitrectomy for complex proliferative diabetic retinopathy

Impact of different manufacturers and gauge sizes on the performance of backflush needle

27‑Gauge vitrectomy vs. 25‑gauge vitrectomy in the management of proliferative diabetic retinopathy with preoperative intravitreal injection of conbercept

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