title: Comparison of clinical outcomes and wound dynamics of sclerotomy ports of 20, 25, and 23 gauge vitrectomy.
abstract: OBJECTIVE
  To compare the benefits, the risks and the dynamics of port closure in different gauge vitrectomy systems.
  
  
  METHODS
  Prospective, randomized, comparative study of 90 eyes undergoing 20, 23 and 25 gauge (G) vitrectomy for uncomplicated vitreous hemorrhage due to proliferative diabetic retinopathy, vasculitis, trauma, venous occlusions and others. An endoscope was used in five cases of each group to visualize the inside of sclerotomy ports.
  
  
  RESULTS
  Vision improved from 0.048 (3/60) to 0.206 (6/24) (p = 0.0021), from 0.069 (4/60) to 0.389 (6/18) (p < 0.0001) and from 0.055 (3/60) to 0.286 (6/24) (p = 0.0010) with 20, 23, and 25-G systems, respectively. Re-bleeds occurred in 4, 1 and 4 eyes of 20, 23 and 25-G systems respectively and post-operative retinal detachment was seen in 2 cases of 20-G system. There were no cases of post-operative hypotony or endophthalmitis seen. With 23 and 25 gauge systems, significant amount of vitreous was seen blocking the inner lip of the sclerotomy ports.
  
  
  CONCLUSIONS
  The small gauge systems are safe and equally effective than the 20-G system for non-complicated vitreous hemorrhage cases with faster recovery and more comfort for the patient. Increased vitreous clogging with small gauge systems does not extrapolate to an increased risk of complications.
authors.affiliation: Retina Foundation, Gujarat, India. drmanishnagpal@yahoo.com
authors.forename: Manish
authors.initials: M
authors.lastname: Nagpal
authors.forename: Sharang
authors.initials: S
authors.lastname: Wartikar
authors.forename: Kamal
authors.initials: K
authors.lastname: Nagpal
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008866:Microsurgery / Q000379:methods*; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012590:Sclera / Q000601:surgery*; D012599:Sclerostomy / Q000379:methods*; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy; D014823:Vitreous Hemorrhage / Q000601:surgery; D014945:Wound Healing / Q000502:physiology*; D055815:Young Adult