Primary vitrectomy for rhegmatogenous retinal detachment in pseudophakic eyes: 20‐gauge versus 25‐gauge vitrectomy. (8th June 2016)

• Record Type: Journal Article
• Authors: Süsskind, Daniela; Neuhann, Irmingard; Hilgers, Ralf‐Dieter; Hagemann, Ulrike; Szurman, Peter; Bartz‐Schmidt, Karl Ulrich; Aisenbrey, Sabine
• Is Part Of: Acta ophthalmologica. Volume 94:Number 8(2016)
• Page Start: 824
• Page End: 828
• Publication Date: 2016-06-08
• Subjects: 25‐gauge vitrectomy -- pars plana vitrectomy -- pseudophakic -- retinal detachment -- transconjunctival sutureless vitrectomy; Ophthalmology -- Periodicals; 617.7005
• DOI: 10.1111/aos.13133
• Languages: English
• ISSNs: 1755-375X

Abstract

Abstract: Purpose: To report anatomical and functional outcome of 20‐gauge versus 25‐gauge primary pars plana vitrectomy for management of complex rhegmatogenous retinal detachment in pseudophakic eyes. Methods: Prospective single‐centre randomized comparative pilot trial. Fifty patients with retinal detachment (RD) not complicated by proliferative vitreoretinopathy grade B or C, who cannot be treated with a single meridional sponge, were randomized (1:1) from November 2006 to January 2010 to either 20‐gauge or 25‐gauge vitrectomy as first surgical intervention and followed up over a 12‐month period, evaluating change in best‐corrected visual acuity, anatomical success and intraocular pressure dysregulation. Results: Mean visual acuity improved by 0.88 (SD 0.67) from 1.22 logMAR (SD 0.63) to 0.34 logMAR (SD 0.31) in the 20‐gauge group and by 0.53 (SD 0.91) from 0.86 logMAR (SD 0.73) to 0.34 logMAR (SD 0.46) in the 25‐gauge group. Final anatomical success rate was 100% and primary success rate was 69% at 6 months of follow‐up. In the 20‐gauge group, the retina was attached after one single procedure in 18 eyes (72%) and in 21 eyes (84%) of the 25‐gauge group. Two patients in the 25‐gauge group had hypotony at the first postoperative day which normalized within 6 weeks. Conclusion: In our series, transconjunctival sutureless 25‐gauge and 20‐gauge vitrectomy showed comparable results in pseudophakic RD not suitable for single sponge surgery with respect to visual outcome and retinal reattachment. Postoperative hypotony does not seem to be a significant problem of transconjunctival sutureless vitrectomy.