title: 23- and 20-gauge vitrectomy with air tamponade with combined phacoemulsification for idiopathic macular hole: a single-surgeon study.
abstract: OBJECTIVE
  To compare the results of 23- and 20-gauge vitrectomies combined with phacoemulsification and aspiration and intraocular lens implantation (phacoemulsification surgery) 1 year after repair of idiopathic macular holes.
  
  
  METHODS
  Retrospective, consecutive, comparative case series.
  
  
  METHODS
  The medical charts of 100 consecutive eyes were reviewed that had undergone either 23- or 20-gauge vitrectomy combined with phacoemulsification surgery to treat an idiopathic macular hole performed by 1 surgeon. The rate of improvement of the logarithm of the minimal angle of resolution visual acuity (VA) was calculated using the formula: (postoperative value - preoperative value) × 100/(1-year postoperative value - preoperative value).
  
  
  RESULTS
  The macular holes closed successfully after the primary vitrectomy in all eyes in both groups. Although the VAs did not differ significantly before surgery or 1 year after surgery between the 2 groups, the VA improvement was significantly greater 1 and 3 months after surgery (P = .02, for both) in the 23-gauge group compared with the 20-gauge group. The induced corneal astigmatism levels 1 week and 1 and 3 months after surgery were significantly lower (P = .01, P = .01, and P = .03, respectively) and the surgical time was significantly shorter (P = .01) in the 23-gauge group than in the 20-gauge group. No apparent complications developed in either group.
  
  
  CONCLUSIONS
  Since 23-gauge vitrectomy combined with phacoemulsification surgery is advantageous because the VA improved rapidly after treating the macular holes with an acceptable safety profile, idiopathic macular holes are a good indication for 23-gauge vitrectomy combined with phacoemulsification surgery.
authors.affiliation: Ohtsuka Eye Hospital, Sapporo, Japan. taiichi-hikichi@hokkaido.med.or.jp
authors.forename: Taiichi
authors.initials: T
authors.lastname: Hikichi
authors.forename: Shoko
authors.initials: S
authors.lastname: Kosaka
authors.forename: Kimitaka
authors.initials: K
authors.lastname: Takami
authors.forename: Hiroko
authors.initials: H
authors.lastname: Ariga
authors.forename: Hideo
authors.initials: H
authors.lastname: Ohtsuka
authors.forename: Makoto
authors.initials: M
authors.lastname: Higuchi
authors.forename: Takuro
authors.initials: T
authors.lastname: Matsushita
authors.forename: Reiko
authors.initials: R
authors.lastname: Matsushita
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000388:Air; D001251:Astigmatism; D004322:Drainage / Q000379:methods; D005260:Female; D006801:Humans; D019654:Lens Implantation, Intraocular; D008297:Male; D008866:Microsurgery / Q000379:methods*; D008875:Middle Aged; D018918:Phacoemulsification; D011183:Postoperative Complications; D012167:Retinal Perforations / Q000145:classification / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy / Q000379:methods*