Comparative study of 27-gauge and 25-gauge vitrectomy performed as day surgery

Abstract

To compare postoperative outcomes of 27-gauge (G) and 25-G vitrectomy conducted as day surgery. In total, 200 consecutive eyes that underwent primary vitrectomy (27-G in 100 eyes, 25-G in 100 eyes) were analyzed. 27-G vitrectomy was performed using a cut rate of 7500cpm and 25-G vitrectomy using a cut rate of 5000cpm. The 27-G and 25-G groups did not differ significantly in underlying diseases and preoperative Early Treatment Diabetic Retinopathy Study (ETDRS) score. The time required for vitrectomy was significantly longer in the 27-G group (35.3 vs. 29.8min, P=0.0013). Postoperative hypotony was observed in 0 and 3 patients, and ocular hypertension in 10 and 14 patients in the 27-G and 25-G groups, respectively, showing more stabilized postoperative ocular pressure in the 27-G group. Gain in ETDRS score was significantly better in the 27-G group (12.1±20.2 letters) compared to the 25-G group (10.0±21.3 letters) (P=0.0323) at 1month post-vitrectomy, but not significantly different at 3 and 6months (P=0.0686 and 0.0543). Rates of postoperative retinal detachment (1 vs. 1%) and vitreous hemorrhage (2 vs. 3%) were not different between two groups. 27-G vitrectomy requires longer operative time than 25-G, but using the 27-G system results in earlier visual improvement and stabilized ocular pressure.