23G Vitrectomy Research Articles

Comparison of effectiveness between complete internal limiting membrane peeling and internal limiting membrane peeling with preservation of the central fovea in combination with 25G vitrectomy for the treatment of high myopic foveoschisis.

Vitrectomy combined with internal limiting membrane peeling (ILMP) treats high myopic foveoschisis with good results, but there is a risk of iatrogenic macular holes, which may be reduced by preserving the internal limiting membrane of the central fovea. This study compared complete ILMP with partial ILMP, both combined with 25G vitrectomy, for the treatment of high myopic foveoschisis.Thirty-three cases (33 eyes) of high myopic foveoschisis were retrospectively analyzed. They underwent 25G vitrectomy combined with C3F8 gas filling; Group A (20 patients, 20 eyes) underwent complete ILMP, while Group B (13 patients, 13 eyes) underwent partial ILMP to preserve the internal limiting membrane of the central fovea. Patients were followed up for 6 months and underwent best corrected visual acuity (BCVA), intraocular pressure, diopter, slit lamp microscopy, indirect ophthalmoscope, A-mode and/or B-mode ultrasound, and optical coherence tomography. Surgical complications were recorded.Up to the last follow-up, the BCVA improved and central fovea thickness (CFT) was lower compared with before surgery in both groups (All P < .05). There were no significant differences in BCVA and CFT at each time point between the groups (P > .05). Most of the postoperative retinas of the 2 groups were completely reattached, with disappearance of the macular retinoschisis cavity. Two patients in the Group A and none in the Group B developed a macular hole during follow-up (P = .508).The results did not support the superiority of partial ILMP over complete ILMP in reduced incidence of macular hole. Both methods had a similar curative effect.

Surgical Management of Intraocular Silicone Oil Microdroplet.

Intraocular silicone oil microdroplets have been described after intravitreal injection of anti-VEGF agents packaged at a compound pharmacy. We present a case with the presence of an intraocular silicone oil microdroplet after a vitreoretinal operation using disposable instruments, and the surgical technique for its removal. A 59-year-old patient who had been operated on for vitreous opacities using a disposable 27-g vitrectomy kit complained of a small round structure floating in the eye. It appeared a few days after surgery. The bubble was not present at all times and it disappeared for days on end. Clinical examination of the vitreous and retina during these uneventful periods was normal. The bubble reappeared intermittently without a link to any specific movement for some time but was again absent once the patient was examined. The physical properties of the mobile round lesion could be identified as lighter than aqueous humor, as it was described as being in the center of the visual field if the head was tilted forward. As the patient was very bothered by this bubble, a 23-g vitrectomy was performed. During deep indentation of the pars plana over 360 degrees, a tiny bubble of silicone oil could be found buried in the peripheral vitreous base, and controlled aspiration under deep indentation was performed. The patient has been without symptoms since the removal of the droplet and made an uneventful clinical recovery. Microdroplets of silicone oil may be present in disposable vitreoretinal instruments and stay in the eye after surgery, causing a visual disturbance. The origin of these droplets may be linked to the plastic tubing of the instruments.

Surgical outcomes of immediate sequential bilateral vitreoretinal surgery for advancing retinopathy of prematurity.

Purpose:Bilateral eye surgery in the same session may be required for advancing stage 4 retinopathy of prematurity (ROP). The purpose of this study was to evaluate the outcomes of immediate sequential bilateral vitreoretinal surgery (ISBVS) in stage 4 ROP.Methods:In a retrospective interventional study at a tertiary care center, 60 eyes of 30 infants who underwent ISBVS for stage 4 ROP between December 2015 and May 2017 were studied. In cases with clear retrolental access, 25G or 27G lens sparing vitrectomy (LSV) was performed and in the rest 25G lensectomy with vitrectomy (LV) was performed through clear corneal entries. The final anatomical outcome measures were the status of tractional retinal detachment (TRD) and macular status.Results:The mean gestational age was 28.4 ± 2.0 weeks and birth weight was 1214.5 ± 329.7gms. The mean postconceptional age at surgery was 40.8 ± 2.2 weeks. Stages 4a and 4b were present in 86.7% and 13.3% eyes respectively. LSV was performed in 95% eyes whereas LV was performed in the rest. None of the eyes developed lens touch, choroidal hemorrhage, postoperative hypotony, corneal decompensation, or endophthalmitis. At last follow-up (mean 45 weeks, range 20–68 weeks), macula was attached in 90% eyes with the TRD resolved completely in 61.7% eyes and significantly decreased in another 25% eyes. Sequalae included macular drag, epiretinal membrane, and progression to fibrotic stage 5 disease.Conclusion:ISBVS is safe and effective for bilateral stage 4 ROP and should be recommended in rapidly progressive cases.

Comparative study of the clinical efficacy of 25G versus 27G vitrectomy for rhegmatogenous retinal detachment with air tamponade

Comparative study of the clinical efficacy of 25G versus 27G vitrectomy for rhegmatogenous retinal detachment with air tamponade

Twenty-three-gauge pars plana approach versus limbal approach for removal of congenital cataracts

Purpose To compare the 23-G vitrectomy system via pars plana approach with the limbal approach for the management of congenital cataract in Egyptian infants attending Mansoura Ophthalmic Center, Delta, Egypt. Patients and methods A total of 30 eyes of 21 infants with congenital cataract who attended Mansoura Ophthalmic Center, Egypt, were included. They were sorted out into two groups; each included 15 eyes. Group I underwent pars plana approach and group II underwent anterior limbal approach for phacoaspiration, posterior capsulorhexis, and anterior vitrectomy. Postoperative examination and follow-up results were recorded. Results There was significant statistical increase in mean duration of surgery in group I (59.27±12.69) than group II (39.93±9.04), with P value less than or equal to 0.001. There was no significant statistical difference in intraocular pressure values at preoperative period, at 1 week, 2 weeks, 1 month, 3 months, and 6 months postoperatively in the studied groups .There was no significant statistical difference in the incidence of visual axis opacification, secondary glaucoma, anterior chamber reaction, capsular phimosis, and wound leak between the two groups. However, there was a significant statistical increase in the incidence of preretinal hemorrhage in group I (26.7%, n=4) when compared with group II (0%, n=0), with P value of 0.032. There was no significant statistical difference in the incidence of secondary glaucoma during a 6-month follow-up period. Conclusion Posterior approach and anterior approach can be used safely for infantile cataract, and the application of the technique depends on surgeon experience and skills.

Observation of vitrectomy combined with Ranibizumab for macular edema

Objective To evaluate the effect of 25G vitrectomy combined with intravitreal injection of Ranibizumab for the treatment of macular edema. Methods The data of 120 eyes of 120 patients from Jan. 2013 to Sep. 2017 were analyzed retrospectively. The patients were divided randomly into 2 groups. The control group, 60 patients, underwent 25G vitrectomy, and the observation group, 60 cases, received 25G vitrectomy after Ranibizumab intravitreal injection. The efficacy of two groups were observed. Results The difference of visual acuity before operation was not statistically significant (t=0.073, P=0.943), at 1, 2 weeks, 1 and 3 months after operation, the difference of visual acuity were statistically significant (F=55.420, P=0.000) between the two groups. The difference of retinal thickness of macular before operation was not statistically significant (t=1.297, P=0.211). At 1, 2 weeks, 1 and 3 months after operation, the difference were statistically significant between the two groups (F=153.634, P=0.000). Operation time were (44.20±6.44) min in the observation group, and (62.44±8.87) min in the control group. The difference was statistically significant between the two groups (t=4.900, P=0.000). The difference of intraoperative bleeding was statistically significant between the two groups (χ2=4.236, P=0.040). Conclusion The treatment of 25G vitrectomy combined with Ranibizumab intravitreal injection before operation for macular edema, can improve visual acuity fastly, regresse of macular edema rapidly and reduce of intraoperative operating time and complications. Key words: Edema, macular; Vitrectomy, 25G; Ranibizumab, intravitreal injection

Investigation of scleral thermal injuries caused by ultrasonic pars plana phacoemulsification and aspiration using pig eyes.

The purpose of this study was to investigate the thermal injuries caused by ultrasonic pars plana phacoemulsification and aspiration (PPPEA) using pig eyes. Using a 20-gauge (G) vitrectomy system (Accurus®, Fragmatome; Alcon Laboratories) in both the 'open-tip' and 'closed-tip' techniques, PPPEA was performed in pig eyes and the subsequent thermal injuries generated around the scleral wound were measured by infrared thermal imaging (thermography). Post surgery, the state of the scleral wound was observed under a microscope, and a tissue slice containing the scleral wound was then prepared and observed under an optical microscope. Thermography measurements revealed a slight temperature rise around the scleral wound in the open-tip case, yet a marked temperature rise in the closed-tip case. The scleral wound incision produced by the open tip was linear, while that produced by the closed tip was expanded. Histological examination revealed mild degeneration of the sclera around the wound in the open-tip case, yet marked tissue degeneration by thermal injuries in the closed-tip case. Our findings showed that in PPPEA, the temperature of the tip of a 20G vitrectomy system rapidly increases due to the closed-tip technique, thus producing obvious thermal damage to the scleral wound. In order to prevent thermal injuries to the scleral wound during PPPEA, it is important to shorten the time of ultrasonic oscillation during surgery as much as possible while the tip is occluded with nuclear fragments.

Development of a full thickness macular hole after vitrectomy for rhegmatogenous retinal detachment: a sequential study via optical coherence tomography

BackgroundTo demonstrate a full thickness macular hole (MH) development after vitrectomy (VT) for rhegmatogenous retinal detachment (RRD) and to investigate the possible disease mechanism with optical coherence tomography (OCT).Case presentationA 47-year-old female underwent 23G vitrectomy surgery to repair the macula-detached RRD successfully. However, intraretinal cysts initially developed two months after surgery. Cysts gradually increased in number and size, and cystoid macular edema was noted at the 5th month. Thereafter, inner retina dehiscence and a lamellar macular hole developed. The lamellar hole further dehisced and progressed into a full-thickness MH at the 10th month. The patient then received 23G vitrectomy and internal limiting membrane peeling surgery. OCT and fundus picture showed macular hole sealed 10 days afterward.ConclusionsThe mechanism of secondary MH included tangential traction, cystoid degeneration of macula, and glial migration. The sequential OCT studies provide evidence to support the disease mechanism of cystoid degeneration of the macula.

Surgical outcomes of 27-gauge and 25-gauge vitrectomy day surgery for proliferative diabetic retinopathy

To compare postoperative outcomes of 27-gauge (G) and 25-G vitrectomy conducted as day surgery for proliferative diabetic retinopathy (PDR). One hundred eighty-five consecutive PDR patients (185 eyes) who underwent primary vitrectomy (27-G in 64 eyes, 25-G in 121 eyes) were analyzed. The 27-G and 25-G groups did not differ significantly in preoperative Early Treatment Diabetic Retinopathy Study (ETDRS) score, age, or preoperative intraocular pressure. The proportions of simultaneous cataract surgery (27-G vs. 25-G: 59.4% vs. 62.4%) and air-filled eyes (76.6% vs. 85.1%) were not significantly different between two groups. Both groups showed significant improvement in ETDRS score at postoperative 1, 3, and 6months (all, P < 0.0001). Mean gain in ETDRS score from baseline was apparently better in 27-G group than in 25-G group at 1, 3, and 6months, but there were no significant differences (1month: 20.3 vs. 13.1 letters, P = 0.0703; 3months: 22.9 vs. 17.5 letters, P = 0.1561; 6months: 24.3 vs. 19.3 letters, P = 0.3313). Operation time was apparently longer for 27-G vitrectomy, but there was no significant difference (54.0 vs. 51.1min, P = 0.3676). The same was observed for postoperative intraocular pressure at postoperative day 1 (19.7 vs. 18.1mmHg, P = 0.1353). Incidence of postoperative retinal detachment (1.6% vs. 0.8%) and reoperation due to vitreous hemorrhage (6.3% vs. 6.6%) was not different between two groups. The 27G system is as safe and as usefulas the 25G system when used for PDR and can be expected to achieve earlier recovery of postoperative visual acuity.

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

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.

Vitrectomy and iOCT-assisted inverted ILM flap technique in patients with full thickness macular holes

In large full thickness macular holes (FTMH) the closure rate after vitrectomy and conventional internal limiting membrane (ILM) peeling is less than 90%. The aim of this study was to examine the visual acuity and anatomical success rate with high-resolution optical coherence tomography (OCT) after transconjunctival sutureless 23-gauge pars plana vitrectomy as well as intraoperative OCT (iOCT) and Brilliant Peel (BP)-assisted ILM peeling using the inverted ILM flap technique in patients with large FTMHs. In this retrospective study 25eyes of 25 consecutive patients with large FTMH were treated by 23-G vitrectomy with BP and iOCT-assisted ILM peeling using the inverted ILM flap technique followed by gas tamponade. In all patients best corrected visual acuity (BCVA) and the maximum diameter, base and height of the FTMH as well as intraretinal alterations were measured preoperatively using high-resolution spectral domain OCT (SD-OCT, Spectralis, Heidelberg Engineering, Germany). The BCVA was measured after 1, 3, and 6months. Additionally, the closure rate and the microstructural integrity of the outer retinal layers, e.g. external limiting membrane (ELM), ellipsoid zone und photoreceptor outer segment (OS) were registered in the SD-OCT and correlated with the results of BCVA after macular hole surgery. In all surgical procedures with the inverted ILM flap technique the application of iOCT enabled agood visualization and acontrolled positioning of the ILM flaps. At baseline mean BCVA was 0.2 (0.7 logMAR) and improved significantly after 1, 3 und 6months to 0.4 (0.4 logMAR), 0.5 (0.3 logMAR) and 0.63 (0.2 logMAR), respectively. The closure rate of the FTMHs was 100%. Microstructural integrity of the outer retinal layers was evaluated semiquantitatively and showed good correlation with BCVA. Vitrectomy with BP and iOCT-assisted ILM peeling using the inverted ILM flap technique in patients with large FTMH is avery controlled and safe microsurgical strategy and shows good functional and anatomical results. The morphology of the FTMH, the ILM flap and the position of the inverted ILM flap under air was well visualized by IOCT. The microstructural integrity of the outer retinal layers is displayed in detail on SD-OCT and represents an important predictive parameter for BCVA after macular hole surgery.

Effectiveness and prognosis of 23G vitrectomy for perforating ocular trauma caused by metallic foreign bodies

Effectiveness and prognosis of 23G vitrectomy for perforating ocular trauma caused by metallic foreign bodies

Differentiated Approach to the Surgical Treatment of Chronic Uveitis in Juvenile Idiopathic Arthritis

The purposeis to analyze the results of complex treatment of chronic uveitis in juvenile idiopathic arthritis.Patients and methods. The study included 26 children (46 eyes) with uveitis associated with JIA aged from 5 to 16 years. All children underwent a comprehensive ophthalmological examination. The patients were divided into 3 groups. The first group included children with anterior uveitis (18 eyes), 3 eyes had iridocyclitis without changing of optical media transparency; precipitates on the endothelium in combination with the rear adhesions and complicated cataract were revealed in 15 eyes. The second group included children with middle and posterior uveitis (12 eyes), where effusion into the vitreous in combination with retinal edema in macular area were shown. The third group included children with panuveitis (16 eyes), where ribbon-like corneal dystrophy in combination with the rear adhesions, complicated cataract, and pericardial effusion of varying severity in the vitreous body traction syndrome, macular edema were revealed. Treatment tactics in each group depended on the characteristics of the pathological process.Results. In the first group, visual acuity in the postoperative period was 0.5–0.8. In the second group, after the conservative drug anti-inflammatory treatment, the pathological process subsided and visual acuity increased up to 0.6–0.8 in 4 eyes. In 3 eyes with a pronounced traction component on the periphery and the presence of vitreomacular traction syndrome, where vitrectomy was performed, visual acuity was 0.3–0.5. After intravitreal “Ozurdex” implantation (5 eyes), diffuse macular edema decreased and visual acuity increased up to 0.7–0.8. In the third group, in cases of intense opacity of the vitreous body due to exudative effusion, a 3-port 25–27G vitrectomy with silicone oil tamponade was performed. Visual acuity after the surgery varied from 0.2 to 0.5.Conclusion. High functional results in children with uveitis associated with JIA were achieved due to modern methods of preoperative diagnosis, advanced surgical techniques, as well as proper management of the patients in the postoperative period.

Soloist performance of vitrectomy probe in proliferative diabetic retinopathy.

To evaluate the feasibility and outcomes of the sole use of 23g pars plana vitrectomy in cases with diabetic vitreous hemorrhage with vitreoretinal traction. Prospective interventional case series involving patients between January 2013 and January 2018. All eyes underwent 23g pars plana vitrectomy with internal tamponade. Intraoperative parameters including ancillary instruments, the methods used for hemostasis and complications were all recorded. Postoperative parameters including anatomic success rate, functional success, and postoperative complications were recorded and analyzed. Patients were followed up for at least 12 months. A total of 68 eyes of 66 patients were included. Intraoperative ancillary instruments were required in 5 (7.4%) eyes. None of the cases required the use of chandelier illumination, endodiathermy, or scissors. Mean best-corrected visual acuity improved significantly from LogMAR 1.67 ± 0.63 preoperative to 1.22 ± 0.38 at 1-year follow-up (P = 0.005). Functional success was achieved in 37 (54.4%) eyes at 1-year follow-up. Iatrogenic breaks occurred in 3 (4.4%) eyes, vitreous hemorrhage in 4 (5.9%) eyes, and epiretinal membranes in 3 (4.4%) eyes. Repeated vitrectomy was done in 3 (4.4%) eyes. The 23g vitrectomy probe proved to be a safe, effective, and beneficial single tool that could accomplish the diabetic vitrectomy mission exclusively with minimal aid from other instruments in cases with vitreous hemorrhage associated with vitreoretinal traction.

A comparison of 23-gauge and 20-gauge vitrectomy for proliferative sickle cell retinopathy - clinical outcomes and surgical management.

To report anatomical and functional outcomes in patients with proliferative sickle retinopathy (PSR) who underwent 23-gauge (23G) and 20-gauge (20G) vitrectomy. Retrospective consecutive case series of patients who underwent vitreoretinal intervention for complications of PSR between April 2009 and February 2015. Operations were performed at a tertiary referral centre, Moorfields Eye Hospital. Visual acuity and anatomical success rates were evaluated for PSR complicated by retinal detachment, tractional vitreous haemorrhage and macular hole. Proliferative diabetic retinopathy cases were excluded. A total of 71 eyes (63 patients) underwent vitreoretinal surgery for PSR complications with 26 months mean follow-up. Primary indications were: tractional retinal detachment (TRD, n = 17), TRD with rhegmatogenous retinal detachment (n = 16), rhegmatogenous retinal detachment (n = 5, macula-on: 1, macula-off: 4), vitreous haemorrhage (n = 19), epiretinal membrane (n = 6), and full thickness macula hole (n = 8). Thirty-nine cases underwent 20G vitrectomy, and 23G surgery was performed in 32 eyes. Mean best corrected visual acuity (BCVA) improved from pre-operative 1.30 LogMAR to final BCVA of 0.74 LogMAR (p < 0.01, paired t-test). 23G vitrectomy yielded slightly better 32 vs. 25 ETDRS-letter improvement compared with 20G vitrectomy (p = 0.60, NS, unpaired t-test). 23G was associated with fewer per-operative complications (23G, 18% vs. 20G,13%). The subset of 38 eyes with retinal detachment demonstrated 79% primary reattachment rate, and a smaller BCVA improvement of 3 lines (p = 0.07, paired t-test). Surgical intervention for complicated PSR can preserve and/or improve vision although the degree of visual acuity stabilisation remains guarded in tractional/rhegmatogenous detachments. 23G vitrectomy may give a better functional outcome with lower per-operative complication rates.

Outcomes of transconjuctival sutureless 27-gauge vitrectomy for stage 4 retinopathy of prematurity

AIMTo report our initial experience with lens-sparing vitrectomy for stage 4 retinopathy of prematurity using the 27-gauge (G) system.METHODSThis retrospective case series involved nine eyes of five babies with active stage 4 ROP, who underwent 27-G lens-sparing vitrectomy. Surgery was done using 27-G valved cannulas and sclerotomies were made 1.5 mm from the limbus. Bilateral sequential vitrectomy was done in eight eyes.RESULTSAt one-year follow-up, anatomical outcome was favourable in all nine (100%) eyes. High-speed cutting and smaller sclerotomies were helpful in reducing the intra and post-operative complications.CONCLUSION27-G vitrectomy is well suited for stage 4 ROP surgeries.

Tips, Tricks, and Advantages of 27-G Vitrectomy

Purpose: We present the advantages and technique variations of 27-G vitrectomy in a variety of surgical retina cases. Methods: Patients with epiretinal membrane, retinal detachment, and proliferative diabetic retinopathy with vitreous hemorrhage and tractional detachments underwent 27-G vitrectomy. We present technique tricks, solutions to various problems and pitfalls, and the advantages of 27-G vitrectomy. Results: Postoperative visual acuity improved significantly in all patients. Anatomical restoration was achieved in all cases. Conclusions: 27-G vitrectomy offers satisfactory outcomes in a wide variety of surgical retina cases and shows significant advantages in the postoperative course.

Changes in the tear film production and quality after 20- and 23-G vitrectomy: a prospective comparative study

Background Dry eye is a common condition affecting many patients after different ocular surgeries. The recent technique of pars plana vitrectomy as 23- or 25-G vitrectomy has an overt advantage over the traditional 20-G vitrectomy in causing less damage to the conjunctival tissue. Patients and methods This is a prospective randomized study, which enrolled 16 eyes that underwent traditional 20-G vitrectomy (group 1) and were compared with 15 eyes that underwent 23-G vitrectomy (group 2). Preoperative and postoperative (first day, first week, first month, and third month) Schirmer 1 (ST1) test and tear break-up time test (TBUT) were used to evaluate the tear film amount and quality. The postoperative symptoms and signs of dry eye were observed and compared in both groups. Results No significant differences were found between the two groups regarding the mean age, sex distribution, comorbidities, and preoperative ST1 or TBUT tests. Both groups experienced excess tears at the first postoperative day. At the end of the first postoperative month, group 1 showed significantly lower values of ST1 and TBUT tests than group 2 (P=0.002 and 0.05 for both tests). Patients in the 23-G group reported significantly less incidence of ocular pain and red eye at the first week and first month after surgery. Conclusion 23-G vitrectomy has less damaging effects on the conjunctival tissue, reflected as less reduction in the tear film quantity and lower rates of dry eye, than the traditional 20-G method.

Removal of giant intraocular foreign body with the assistance of silicone oil tamponade in 23G vitrectomy

Removal of giant intraocular foreign body with the assistance of silicone oil tamponade in 23G vitrectomy

Comparison of 23 Gauge Transconjunctival releasable Suture Vitrectomy with standard 20 gauge Vitrectomy.

Objective:To compare effectiveness of releasable transconjunctival sutures in 23 gauge vitrectomy and standard 20 gauge vitrectomy.Methods:This prospective comparative study was conducted in Department of Vitreoretinal Surgery, Al Ehsan Eye Hospital, Lahore from June 2016 to March 2017. It included 84 patients in total (Group-A: 42 patients underwent 23 gauge releasable suture vitrectomy; Group-B: 42 patients who underwent standard 20 gauge vitrectomy). Pre operative and post operative best corrected visual acuity, surgical duration, pre and post operative intraocular pressure and complication profile was compared between two groups.Results:The leading cause for vitrectomy was vitreous haemorrhage. (Group-A; n=15 ;35.71%; Group-B; n=17; 40.47%). There was statistically significant improvement in preoperative and postoperative BCVA in both groups (Group A: P-value < 0.05; Group B P-value < 0.05) but there was no significant difference in post operative BCVA between two groups at 3 months (P-value > 0.05). Surgical time for 23G vitrectomy Group was statistically less than 20 G vitrectomy Group (51 +/-18 minutes for Group-A versus 78 +/- 13 minutes for Group-B; p-value < 0.05). Visual analog score for pain / discomfort was also significantly less for Group-A than Group-B. There was no significant difference in intraocular pressures between the two groups.Conclusions:Releasable suture technique for small gauge vitrectomy is a safe and easily adaptable technique that has certain significant advantages over 20G absorbable suture vitrectomy.