Postoperative complications associated with 25-gauge pars plana vitrectomy.
To report postoperative complications in eyes undergoing 25-gauge pars plana vitrectomy (PPV).



Seventy consecutive eyes that underwent 25-gauge PPV for various indications, including epiretinal membrane, non-clearing vitreous hemorrhage, and idiopathic macular hole, and had a minimum follow-up of 12 weeks were reviewed retrospectively. Main outcome measures included best-corrected Snellen visual acuity, intraocular pressure (IOP), intraoperative complications, and postoperative complications.



The mean visual acuity improved from 20/368 preoperatively to 20/105 postoperatively (P < .00005). Intraoperative complications included retinal tears in 2 eyes (2.9%). Postoperative complications included cataract progression in 17 eyes (42.5%), cystoid macular edema exacerbation in 5 eyes (7.1%), and retinal detachment in 1 eye (1.4%). Postoperative day 1 IOP was statistically lower than preoperative IOP in fluid-filled eyes (P = .031) but not in eyes filled with intravitreal air (P = .30) or gas (P = .52). Sclerotomy sutures were required intraoperatively in 5 eyes (7.1%) and postoperative day 1 hypotony was noted in 4 eyes (5.7%). All of these complications were noted in fluid-filled eyes except for one case of postoperative day 1 hypotony with gas tamponade.



Intraoperative and postoperative complications were rare in this series of 25-gauge PPV. Postoperative cataract progression and hypotony were the most common complications. Fluid-filled eyes appear to have a higher risk of wound leakage and postoperative hypotony after 25-gauge PPV than eyes with air or gas tamponade.
Retina Service, Wills Eye at Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
Omesh P I
OP
Gupta
Eric D
ED
Weichel
Carl D
CD
Regillo
Mitchell S
MS
Fineman
Richard S
RS
Kaiser
Allen C
AC
Ho
J Arch
JA
McNamara
James E
JE
Vander
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002386:Cataract / Q000209:etiology; D018450:Disease Progression; D019773:Epiretinal Membrane / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007429:Intraocular Pressure; D007431:Intraoperative Complications; D008297:Male; D008875:Middle Aged; D015814:Ocular Hypotension / Q000209:etiology; D011183:Postoperative Complications; D012167:Retinal Perforations / Q000601:surgery; D012189:Retrospective Studies; D014792:Visual Acuity; D014821:Vitrectomy / Q000009:adverse effects*; D014823:Vitreous Hemorrhage / Q000601:surgery