Untoward outcomes in 25-gauge versus 20-gauge vitreoretinal surgery.
OBJECTIVE
This study compares the incidence of complications in eyes undergoing 25-gauge versus 20-gauge vitreoretinal procedures.


METHODS
Retrospective case series. A chart review of consecutive patients who underwent primary 25-gauge (129 eyes) and 20-gauge (129 eyes) vitreoretinal surgery by four surgeons at a single center between September 2002 and November 2005 was conducted.


RESULTS
Mean follow-up was 9.1 +/- 4.9 months in 25-gauge eyes and 14.3 +/- 8.4 months in 20-gauge eyes (P < 0.01). Intraoperative complications were mainly rhegmatogenous in nature and occurred at statistically similar incidence (4.7% in 25-gauge eyes, 6.9% in 20-gauge eyes). Postoperative complications that were significantly associated with surgical method included hypotony and serous choroidal effusions (7.9% in 25-gauge eyes, 1.6% in 20-gauge eyes, P = 0.02). Other postoperative complications noted included retinal tears and detachments (5.4% in 25-gauge eyes, 4.7% in 20-gauge eyes), persistent vitreous hemorrhage (5.4% in each group), and new vitreous hemorrhage (3.9% in 25-gauge eyes, 0.8% in 20-gauge eyes). Endophthalmitis was noted only in 25-gauge eyes in 2 cases (1.6%). Cataract progression occurred at similar rates in both groups (46%).


CONCLUSIONS
25-gauge surgery is associated with a significantly greater incidence of postoperative serous choroidal effusions and hypotony. Of particular concern in 25-gauge surgery is the increased risk of associated endophthalmitis. Operative indications and case selection may be important in minimizing the tendency toward certain postoperative events.
Shaikh
Saad
S
Central Florida Retina Consultants, Orlando, Florida, USA.
Ho
Son
S
Richmond
Preston P
PP
Olson
John C
JC
Barnes
C Durham
CD
D000368:Aged; D005128:Eye Diseases / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007431:Intraoperative Complications; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects; D013508:Ophthalmologic Surgical Procedures / Q000009:adverse effects*; D011183:Postoperative Complications; D012164:Retinal Diseases / Q000601:surgery*; D012189:Retrospective Studies; D014792:Visual Acuity; D014822:Vitreous Body / Q000601:surgery*