Abstract
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.
Highlights
Par plana vitrectomy (PPV), first introduced in 1971, has been widely used to treat posterior segment ocular diseases [1] and has evolved progressively driven by the desire for smaller instruments and greater functionality
June 30, 2017. is study has been proved by the Institutional Review Committee of SPPH and written informed consent was obtained from all patients before surgery. e procedures used conformed to the tenets of the Declaration of Helsinki. e inclusion criterion was primary rhegmatogenous retinal detachment (RRD). e exclusion criteria were previous scleral buckling (SB) or vitrectomy, combined SB, trauma, proliferative vitreoretinopathy (PVR) of grade C, and significant ocular comorbidities such as uveitis, uncontrolled glaucoma, and severe or proliferative diabetic retinopathy
E mean surgical time of 27G vitrectomy was gradually shortened, when the surgeon’s surgical technique was more and more adept. e mean operative time used to treat the second half of the RRD cases in the 27G group was 42.6 ± 16.3 min, which was significantly shorter than that of the first half (68.8 ± 45.4 min, n 17) (P 0.032, Figure 1)
Summary
Par plana vitrectomy (PPV), first introduced in 1971, has been widely used to treat posterior segment ocular diseases [1] and has evolved progressively driven by the desire for smaller instruments and greater functionality. The feasibility of 27G MIVS has been demonstrated for various vitreoretinal diseases, including primary rhegmatogenous retinal detachment (RRD) [6,7,8,9,10,11,12]. There are only two prospective, comparative studies between 27G and 25G. MIVS for RRD in a relatively small number (30 to 40 eyes) of patients so far [10, 13]. E purpose of this study was to retrospectively compare the safety and effectiveness of 27G MIVS with 25G MIVS for the treatment of primary RRD in 92 patients. Is study would expand our current knowledge of the safety and effectiveness of the 27G MIVS MIVS for RRD in a relatively small number (30 to 40 eyes) of patients so far [10, 13]. e purpose of this study was to retrospectively compare the safety and effectiveness of 27G MIVS with 25G MIVS for the treatment of primary RRD in 92 patients. is study would expand our current knowledge of the safety and effectiveness of the 27G MIVS
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