Retrospective Comparison of 25-Gauge Transconjunctival Sutureless Vitrectomy to 20-Gauge Vitrectomy for the Repair of Pseudophakic Primary Inferior Rhegmatogenous Retinal Detachment

Abstract

Outcomes of 20-gauge versus 25-gauge PPV for the management of pseudophakic inferior rhegmatogenous retinal detachments were not significantly different, with hypotony being the most significant postoperative complication in the 25-gauge group as compared with the 20-gauge group.

Comparison of outcomes: scleral buckling and pars plana vitrectomy versus vitrectomy alone for primary repair of rhegmatogenous retinal detachment

“…Surgeons have several effective options for primary RRD repair, including SB alone, PPV alone, SB with PPV, and pneumatic retinopexy. The preferred technique for RRD generically and specifically has been extensively discussed and debated in the literature, but the trend has leaned toward PPV alone for repair of primary RRD 9,11,20–23…”

“…Phakic, aphakic, and pseudophakic eyes were included in the study. Subsequent publications have confirmed the excellent visual and anatomic success of PPV without SB for repair of primary RRD in phakic and pseudophakic patients 9,15,17,23–25. In the past decade, several studies have examined whether the addition of SB during a planned PPV increases the SSAS but to date no prospective study has investigated this topic.…”

“…Certain characteristics traditionally associated with higher risk for primary surgical failure have been used to justify placement of SB at the time of PPV, including extensive lattice degeneration, large detachment size, phakic lens status, pre-existing PVR, and inferior breaks 4,5,12,14,16. However, other evidence suggests that a supplemental SB offers no additional benefit over PPV alone in these situations 2,3,9,10,15,17. Given this unresolved controversy in the medical literature, we performed a retrospective case review with secondary case–control series to examine whether utilization of SB at the time of PPV improved the SSAS for medium- to high-complexity RRDs or helped reduce the incidence of recurrent retinal detachment (RD) when PVR developed.…”

Twenty-Five-Gauge Vitrectomy for the Removal of 5000 Centistokes Silicone Oil

“…18 Since the development of 25-gauge transconjunctival sutureless vitrectomy system, there has been a growing body of evidence supporting its effectiveness in the treatment of variety of retinal pathologies. [19][20][21][22][23][24][25][26][27] Using sutureless sclerotomies to access the vitreous cavity for the silicone oil removal offers the advantage of avoiding conjunctival dissection in the eyes that have already undergone previous complicated surgeries. There have only been a few reports in the literature describing sutureless removal of silicone oil.…”

Sutured Versus Sutureless Sclerotomies after 25 Gauge Vitrectomy without an Internal Tamponade

“…The incidence of hypotony after 25-gauge vitrectomy has been described in several prospective and retrospective case series and was reported to be anywhere between 0% to 20% on post-operative day one [4,[6][7][8][9][10][11][12][13]. It has been noted to occur even in cases of 25-gauge vitrectomy that had sutures placed at the conclusion of surgery to close sclerotomies that appeared to persistently leak after cannula removal [7].…”