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.
Central Florida Retina Consultants, Orlando, Florida, USA.
Saad
S
Shaikh
Son
S
Ho
Preston P
PP
Richmond
John C
JC
Olson
C Durham
CD
Barnes
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*