Retrospective comparison of 25-gauge transconjunctival sutureless vitrectomy to 20-gauge vitrectomy for the repair of pseudophakic primary inferior rhegmatogenous retinal detachment.
OBJECTIVE
To compare anatomical and functional outcomes of 25-gauge transconjunctival sutureless pars plana vitrectomy (PPV) to standard 20-gauge 3-port PPV for the treatment of pseudophakic rhegmatogenous retinal detachments with inferior breaks.


METHODS
Retrospective review of 78 consecutive eyes from 78 patients undergoing primary vitrectomy with a minimum of 3-month follow-up. Thirty patients underwent 25-gauge PPV and 48 patients underwent 20-gauge PPV from May 1993 to July 2008. Variables and outcome measures included patient demographics, retinal reattachment, best-corrected visual acuity, macular status, postoperative intraocular pressures, and surgical complications.


RESULTS
Preoperative characteristics were similar in both groups. Single operation success rate was 25/30 (83.3%) for 25-gauge cases and 43/48 (89.6%) for 20-gauge cases (P = 0.50). Transient hypotony occurred in 6/30 25-gauge eyes and 1/48 20-gauge eyes (P = 0.01), whereas hypertension occurred in 10/30 25-gauge cases and 15/48 20-gauge cases. All but 2 eyes were attached at final follow-up (97%). At final follow-up, mean best-corrected visual acuity was 0.28 and 0.32 for the 25-gauge and 20-gauge groups (P = 0.74).


CONCLUSIONS
Outcomes of 20-gauge versus 25-gauge PPV for the management of pseudophakic inferior rhegmatogenous retinal detachments were not significantly different, with hypotony being the most significant postoperative complication in the 25-gauge group as compared with the 20-gauge group.
Colyer
Marcus H
MH
The Retina Group of Washington, Fairfax, Virginia 22031, USA.
Barazi
Mohammed K
MK
von Fricken
Manfred A
MA
D000368:Aged; D000369:Aged, 80 and over; D003228:Conjunctiva; D003452:Cryosurgery; D005260:Female; D005466:Fluorocarbons / Q000008:administration & dosage; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D007431:Intraoperative Complications; D017075:Laser Coagulation; D008297:Male; D008866:Microsurgery / Q000379:methods*; D008875:Middle Aged; D015814:Ocular Hypotension / Q000209:etiology; D011183:Postoperative Complications; D019591:Pseudophakia / Q000150:complications / Q000601:surgery*; D012163:Retinal Detachment / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D012189:Retrospective Studies; D013459:Sulfur Hexafluoride / Q000008:administration & dosage; D013536:Suture Techniques; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy / Q000379:methods*
D005466:Fluorocarbons; C042852:perflutren; D013459:Sulfur Hexafluoride