Postoperative Complication Rates in 23- vs 25-Gauge Pars Plana Vitrectomy. (September 2018)

• Record Type: Journal Article
• Authors: Igelman, Austin D.; Johnson, John A.; Taylor, Stanford C.; Alonzo, Brock J.; Bailey, Steven T.; Lauer, Andreas K.; Hwang, Thomas S.; Lin, Phoebe; Campbell, John P.; Choi, Dongseok; Flaxel, Christina J.
• Is Part Of: Journal of vitreoretinal diseases. Volume 2:Number 5(2018)
• Page Start: 272
• Page End: 275
• Publication Date: 2018-09
• Subjects: 23-gauge -- 25-gauge -- complications -- pars plana -- vitrectomy; Retina -- Diseases -- Periodicals; Vitreous body -- Diseases -- Periodicals; Retina -- Diseases; Vitreous body -- Diseases; Periodicals; 617.735005
• DOI: 10.1177/2474126418785824
• Languages: English
• ISSNs: 2474-1264

Abstract

Purpose: The purpose of this study was to compare rates of clinically significant complications between 23- and 25-gauge pars plana vitrectomy (PPV) in vitreoretinal surgery. Methods: Demographics, PPV indication, and surgical complications were reviewed. Patients with prior PPV or other retina surgery; cases requiring silicone oil removal, keratoplasty, or glaucoma valve implant; patients <18 years old; or patients with <4 months of follow-up were excluded. Comparative and descriptive statistics were used to evaluate the data. Results: A total of 579 eyes met inclusion criteria, and their charts were reviewed. Demographics, PPV indication, follow-up time, and lens status were similar ( P > .05). A 23-gauge PPV was performed more frequently than a 25-gauge PPV (328 vs 251 eyes, respectively). Although rates of eyes with a clinically significant postoperative complication requiring surgical intervention were higher in 23-gauge PPV (112/325, 34.4%) than in 25-gauge PPV (54/250, 21.6%), PPVs indicated by rhegmatogenous retinal detachment were more common with 23-gauge PPVs (155/325, 47.7%) than with 25-gauge PPVs (37/250, 14.8%; P <.001) and were more likely to have postoperative complications; however, rates of recurrent retinal detachments were not different in the 2 cohorts ( P = .862). When controlling for differences in indication, there was a moderately higher rate of postoperative complications following 23-gauge PPV ( P = .063). Conclusions: This retrospective review suggests that clinically significant complications are moderately more likely following 23-gauge PPV compared with 25-gauge PPV, even when the differences in surgical indication are considered.