title: Outcomes of 140 consecutive cases of 25-gauge transconjunctival surgery for posterior segment disease.
abstract: OBJECTIVE
  To evaluate the safety and efficacy of 25-gauge instrumentation for a variety of vitreoretinal conditions on previously nonvitrectomized eyes.
  
  
  METHODS
  Single-center, retrospective, interventional case series.
  
  
  METHODS
  One-hundred forty eyes of 140 patients were evaluated at the Doheny Retina Institute from July 2002 to July 2003.
  
  
  METHODS
  All patients underwent surgical procedures using the Millennium 25-gauge Transconjunctival Standard Vitrectomy system. Twenty eyes (14.3%) underwent procedures without vitrectomy.
  
  
  METHODS
  Postoperative visual acuity (VA), intraocular pressure, surgical time, postoperative inflammation, complications, and number of sutured sites.
  
  
  RESULTS
  No intraoperative complications were noted. No cases required conversion to 20-gauge machines. Ten cases (7.1%) involved single-site sclerotomy suture placement due to bleb formation at the conclusion of the procedure, but 5 of these entry sites were enlarged to facilitate larger instrumentation for tissue manipulation. Median VA improved from 20/250 (logarithm of the minimum angle of resolution, 1.08+/-0.47) preoperatively to 20/60 (0.47+/-0.30) (P<0.0001) at final visit. Mean follow-up was 33.8+/-9.7 weeks, and all eyes were observed for a minimum of 12 weeks. Mean total surgical time was 17.4+/-6.9 minutes. Intraocular pressures remained stable throughout the postoperative course. Five eyes (3.8%) presented on day 1 with shallow choroidal detachments, but all resolved by day 7, and none required volume infusion during the postoperative period. All but one of these cases was within the first 50 procedures performed. No detectable inflammation was noted in any eyes by 4 weeks postoperatively. No case of retinal detachment or endophthalmitis was recorded.
  
  
  CONCLUSIONS
  Transconjunctival surgery using 25-gauge instrumentation may hasten postoperative recovery by decreasing overall surgical time and postoperative inflammation. Procedures requiring minimal intraocular manipulation did not require sutures and, thus, may be better suited for this surgical modality.
authors.affiliation: Doheny Retina Institute, Doheny Eye Institute, Department of Ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles, California 90033, USA.
authors.forename: Rohit R
authors.initials: RR
authors.lastname: Lakhanpal
authors.forename: Mark S
authors.initials: MS
authors.lastname: Humayun
authors.forename: Eugene
authors.initials: E
authors.lastname: de Juan
authors.forename: Jennifer I
authors.initials: JI
authors.lastname: Lim
authors.forename: Lawrence P
authors.initials: LP
authors.lastname: Chong
authors.forename: Tom S
authors.initials: TS
authors.lastname: Chang
authors.forename: Michael
authors.initials: M
authors.lastname: Javaheri
authors.forename: Gildo Y
authors.initials: GY
authors.lastname: Fujii
authors.forename: Aaron C
authors.initials: AC
authors.lastname: Barnes
authors.forename: Terry J
authors.initials: TJ
authors.lastname: Alexandrou
mesh_terms: D000368:Aged; D003228:Conjunctiva / Q000601:surgery; D005128:Eye Diseases / Q000601:surgery*; D005260:Female; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D012164:Retinal Diseases / Q000601:surgery*; D012189:Retrospective Studies; D012449:Safety; D016896:Treatment Outcome; D014792:Visual Acuity; D014821:Vitrectomy / Q000295:instrumentation* / Q000379:methods; D014822:Vitreous Body / Q000601:surgery*