Surgical Outcomes of 27-Gauge Vitrectomy for a Consecutive Series of 163 Eyes With Various Vitreous Diseases

Yoneda, Kazuhito; Morikawa, Keisuke; Oshima, Yusuke; Kinoshita, Shigeru; Sotozono, Chie

doi:10.1097/iae.0000000000001442

Cited by 34 publications

(31 citation statements)

References 31 publications

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“…Similar to previous studies [ 10 , 13 , 19 ], last visit BCVA increased significantly in both the 25G and the 27G groups ( P < 0.001). In terms of the visual improvement (>0.2 logMAR) ratio at last visit, there was no statistically significant differences between groups ( P =0.177).…”

Section: Discussionsupporting

confidence: 89%

Retrospective Comparison of 27-Gauge and 25-Gauge Microincision Vitrectomy Surgery with Silicone Oil for the Treatment of Primary Rhegmatogenous Retinal Detachment

Zhao

Liu

et al. 2018

Journal of Ophthalmology

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Aim To retrospectively compare the safety and effectiveness of 27-gauge (27G) microincision vitrectomy surgery (MIVS) with 25-guage (25G) MIVS for the treatment of primary rhegmatogenous retinal detachment (RRD) with silicone oil tamponade. Methods Ninety-two patients with RRD who underwent MIVS from May 1, 2015, to June 30, 2017, were included in this study. Fifty-eight eyes underwent 25G MIVS and 34 eyes underwent 27G MIVS. We analyzed the characteristics of the patients, surgical time, main clinical outcomes, and rate of complications. Results The mean surgical time was 56.7 ± 35.9 min for the 25G MIVS and 55.7 ± 36.1 min for the 27G MIVS, and there was no significant difference (P=0.894) between the two groups. The primary anatomical success rate after a single operation was 94.8% for 25G MIVS and 91.2% for 27G MIVS (P=0.666). Baseline and final visit best-corrected visual acuity (BCVA) were 1.9 ± 1.1 and 1.0 ± 0.8 in the 25G group, and 1.7 ± 1.0 and 1.1 ± 0.8 in the 27G group. Last visit BCVA increased significantly in both groups (P < 0.001). However, there were no significant differences in terms of visual improvement ratio (>0.2 logMAR) between the two groups (P=0.173). No severe intraoperative complication was observed. Iatrogenic retinal breaks occurred in 2 eyes (3.4%) in the 25G group and 1 eye (2.9%) in the 27G group during the peripheral vitreous base shaving. The transient ocular hypertension (>25 mmHg) within postoperative week 1 was 25.9% in the 25G group and 11.8% in the 27G group (P=0.120). Conclusions This study found no significant anatomical or functional difference between 27G and 25G MIVS in the treatment of primary RRD. Therefore, 27G vitrectomy appears to be a safe and effective surgery for the treatment of primary RRD.

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Section: Discussionsupporting

confidence: 89%

Retrospective Comparison of 27-Gauge and 25-Gauge Microincision Vitrectomy Surgery with Silicone Oil for the Treatment of Primary Rhegmatogenous Retinal Detachment

Zhao

Liu

et al. 2018

Journal of Ophthalmology

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“…Nowadays, progress in vitrectomy devices, stiffness of instruments and light sources have led to the development of 27G (0.4 mm in diameter) transconjunctival sutureless vitrectomy [3]. The use of 27G PPV in the treatment for posterior segment diseases [4][5][6] becomes more and more common, including the surgical treatment of some macular diseases, such as epiretinal membranes. There are no conclusive study results in the literature available that would indicate superiority of 27G vitrectomy over 25G vitrectomy in the treatment for epiretinal membranes [7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%

Comparison of 27-gauge versus 25-gauge vitrectomy results in patients with epiretinal membrane: 6-month follow-up

et al. 2020

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Purpose To compare the 27G versus 25G vitrectomy in patients with epiretinal membrane (ERM). Patients and methods Sixty pseudophakic eyes of 60 consecutive patients treated by pars plana vitrectomy (PPV) using 27G (30 eyes) or 25G (30 eyes) were prospectively evaluated including eye's inflammation, surgery time, ERM ? ILM removal time and complications. Additionally, 1, 3, 7, 14, 30, 90 and 180 days after PPV, the following were estimated: intraocular pressure (IOP), sclerotomy wound closure time, distance best corrected visual acuity (DBCVA), foveal macular thickness (FMT) and surgically induced astigmatism (SIA). Results The eye's inflammation resolved within 30 days after surgery in both groups. The surgery and ERM ? ILM times were longer in the 27G group (p B 0.02). The most common postoperative complication was hypotony in both groups, more common in 25G group (23.3% vs. 10% of eyes). In 27G group, the mean IOP prior to 180 days postoperatively was higher (p \ 0.05) and the sclerotomy wound closure time was shorter (p \ 0.001). Mean DBCVA values (7, 14, 30 days after surgery) were significantly better in 27G group (p \ 0.001). The mean FMT values were similarly and significantly reduced in both groups 1 day postoperatively (p \ 0.05) as compared to preoperative values and then stabilized during follow-up. Mean SIA was lower in 27G group 30, 90 and 180 days after surgery (p \ 0.001). Conclusion The use of 27G PPV in patients with ERM significantly reduced sclerotomy wound closure time and surgically induced astigmatism, better stabilized intraocular pressure and allowed to achieve faster visual acuity improvement, as compared to 25G PPV. Keywords Epiretinal membrane Á 27-gauge Á 25-gauge Á Pars plana vitrectomy Á Visual acuity Á Surgery time Á Self-sealing sclerotomy time Á Intraocular pressure Á Complications

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“…However, inserting a tube into the PP requires complete PPV to prevent vitreous occlusion of the tube, necessitating the added cost and time for a vitreoretinal surgeon to be present. This also increases the risk of various postoperative complications such as retinal tears or cataract progression associated with a PPV [15][16][17]. Our approach of inserting the tube into CS space applies a similar concept, but with a simpler approach and avoiding the additional cost and risk of complications.…”

Section: Case Reports In Ophthalmological Medicinementioning

confidence: 99%

“…This reduces the extraocular portion of the tube where it is subjected to the exposure, desiccation, and mechanical trauma from the eyelid [12][13][14]. However, PP placement requires concurrent pars plana vitrectomy (PPV) and may subject the patient to additional perioperative risks such as retinal tears, cataract progression, macular edema exacerbation, postoperative hypotony, or retinal detachment [15][16][17]. Here, we reported two cases with repeated tube exposure repaired by repositioning the tubes into the ciliary sulcus (CS) without requiring PPV with long-term success.…”

Section: Introductionmentioning

confidence: 99%

A Novel Technique for Recurrent Tube Exposure Repair

Kang¹,

Hsia²,

Han³

2020

Case Reports in Ophthalmological Medicine

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Purpose. Tube exposure can lead to vision-threatening consequences and requires prompt surgical attention. Posterior repositioning of the tube to the pars plana has previously been reported as a successful technique. However, this method requires a pars plana vitrectomy (PPV). Here, we describe a novel technique of repositioning the tube into the ciliary sulcus without requiring PPV. Methods. This is a retrospective interventional case report of two patients who had undergone prior glaucoma drainage device implantation and prior tube exposure repair and developed recurrent tube exposure. Tube exposure in the subjects was repaired by repositioning the tube in the ciliary sulcus. Results. The two eyes remained exposure free postoperatively with 51- and 60-month follow-ups. Conclusions. Repositioning the tube to the ciliary sulcus may be an effective technique to avoid reexposure.

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Surgical Outcomes of 27-Gauge Vitrectomy for a Consecutive Series of 163 Eyes With Various Vitreous Diseases

Cited by 34 publications

References 31 publications

Retrospective Comparison of 27-Gauge and 25-Gauge Microincision Vitrectomy Surgery with Silicone Oil for the Treatment of Primary Rhegmatogenous Retinal Detachment

Retrospective Comparison of 27-Gauge and 25-Gauge Microincision Vitrectomy Surgery with Silicone Oil for the Treatment of Primary Rhegmatogenous Retinal Detachment

Comparison of 27-gauge versus 25-gauge vitrectomy results in patients with epiretinal membrane: 6-month follow-up

A Novel Technique for Recurrent Tube Exposure Repair

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