Surgical outcomes of 25-gauge transconjunctival vitrectomy combined with cataract surgery for vitreoretinal diseases.
BACKGROUND
To report surgical outcomes of 25-gauge transconjunctival vitrectomy combined with cataract surgery for the management of a variety of vitreoretinal diseases.


METHODS
A retrospective, interventional case study was conducted. Chart review of a consecutive series of 150 eyes of 144 patients who underwent 25-gauge vitrectomy combined with phacoemulsification and intraocular lens implantation for epiretinal membrane (n = 62), refractory macular oedema associated with retinal vascular disorders (n = 29), idiopathic macular hole (n = 21), non-clearing vitreous haemorrhage (n = 18), rhegmatogenous retinal detachment (n = 11), tractional retinal detachment associated with proliferative diabetic retinopathy (n = 7), and subretinal haemorrhage (n = 2). Main outcome measures included preand postoperative visual acuity, operating time, intraocular pressure, intra- and postoperative complications.


RESULTS
The mean follow-up period was 9.7 months (range, 6 to 26). The mean overall visual acuity improved from 20/100 preoperatively to 20/38 at final visit (P <0.001). Statistically significant improvement of visual acuity was also observed in each subgroup. Operative time was shortened in macular surgery. No intraoperative complications were noted attributable to small-gauge instruments and no cases required conversion to 20-gauge standard instrumentation. However, 12 eyes (8%) required suture placement to at least one sclerotomy site. Postoperative intraocular pressure remained stable in most cases except 18 eyes (13%) with transient hypotony during the first week after surgery. One case of retinal detachment but no case of endophthalmitis was observed throughout the follow-up period.


CONCLUSIONS
25-gauge vitrectomy combined with cataract surgery is a safe and effective system for the management of a variety of vitreoretinal diseases, especially cases requiring minimal intraocular manipulation. Further study is recommended to evaluate potential postoperative complications.
Oshima
Yusuke
Y
Department of Ophthalmology, Osaka University Medical School, Suita, Japan. oshima@ophthal.med.osaka-u.ac.jp
Ohji
Masahito
M
Tano
Yasuo
Y
D000368:Aged; D005260:Female; D006801:Humans; D019654:Lens Implantation, Intraocular; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification; D012164:Retinal Diseases / Q000150:complications / Q000601:surgery*; D016896:Treatment Outcome; D014821:Vitrectomy / Q000379:methods; D014823:Vitreous Hemorrhage / Q000150:complications / Q000601:surgery*