27-, 25-, and 23-gauge vitrectomy in epiretinal membrane surgery: A comparative study

Session Details

Session Title: Free Paper Session 1: Vitreoretinal Surgery I

Session Date/Time: Thursday 07/09/2017 | 09:00-10:30

Paper Time: 09:54

Venue: Room 111

First Author: : A.Volinia ITALY

Co Author(s): :    P. Rossini   A. Saitta   A. Bratu   F. D'Amati   D. D'Eliseo                 

Abstract Details

Purpose:

To compare the safety and functional outcomes of 27-gauge, 25-gauge and 23-gauge micro-incision vitrectomy surgery (MIVS) instrumentation in the treatment of epiretinal membranes (ERM).

Setting:

Hospital 'Santa Maria delle Croci' of Ravenna, Italy

Methods:

Studied retrospectively. 79 patients with idiopathic ERM were recruited for this study. In group 1 (n=29) we performed a 23G pars plana vitrectomy, in group 2 (n=25) patients underwent to a 25G pars plana vitrectomy and in group 3 (n=25) were operated on using a 27G pars plana vitrectomy. The ERM was removed and the internal limiting membrane (ILM) was peeled in all eyes. The follow-up interval ranged from 6 to 36 months. Intraoperative and postoperative complications and long-term visual outcome are reported and compared.

Results:

Preoperative VA median were 20/63 (23 gauge), 20/50 (25 gauge) and 20/63 (27 gauge). At the end of the follow-up VA median did not differ significantly between the 3 groups: it was 20/40 in all groups. Preoperative central macular thickness (CFT) median were 428.85 µm (23 gauge), 508.47 µm (25 gauge) and 446.42 µm (27 gauge). Postoperative CFT median were 329.37 µm (23 gauge), 372.25 µm (25 gauge), 369.38 µm (27 gauge). The incidence of complications was not statistically significant between the three groups. Complications were 1 intraoperative RRD (27 gauge), 0 postoperative RRD and endophthalmitis were observed. In the postoperative period 8 eyes (5.76 %) developed a cystoid macular edema, not present at the baseline (23 gauge and 25 gauge).

Conclusions:

Our results showed that all techniques described in our study are equally effective in relieving vitreomacular adhesion, in resolving macular edema and also in improving visual acuity. The visual outcome was not correlated with the type of surgical techniques (23G, 25G or 27G), but depends on the integrity of the external limiting membrane end on the health of the photoreceptors.

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