title: Incidence of iatrogenic peripheral retinal breaks in 23-gauge vitrectomy for macular diseases.
abstract: OBJECTIVE
  To assess the incidence of iatrogenic peripheral retinal breaks in 23-gauge vitrectomy for macular diseases and to compare it with 20-gauge vitrectomy.
  
  
  METHODS
  Retrospective, comparative, interventional case series. We compared the incidence of iatrogenic peripheral retinal breaks in 176 eyes undergoing 23-gauge vitrectomy between January 2007 and November 2009 (23-gauge group) and 153 eyes undergoing 20-gauge vitrectomy between January 2004 and June 2006 (20-gauge group) for either idiopathic macular holes or idiopathic epiretinal membranes. All surgeries were performed by one surgeon at a single hospital. Main outcome measure was the incidence rate of iatrogenic peripheral retinal breaks discovered intraoperatively and postoperatively.
  
  
  RESULTS
  Iatrogenic peripheral retinal breaks occurred in 1 eye in the 23-gauge group and in 11 eyes in the 20-gauge group during surgery. Additional iatrogenic retinal breaks were found in 1 eye in the 23-gauge group and in 2 eyes in the 20-gauge group within 1 month after surgery. The overall incidence of iatrogenic peripheral retinal breaks was 1.1% (2 of 176) in the 23-gauge group and 8.5% (13 of 153) in the 20-gauge group. The difference was statistically significant (P = 0.0023).
  
  
  CONCLUSIONS
  The incidence of iatrogenic peripheral retinal breaks during vitrectomy for macular diseases is significantly lower in 23-gauge vitrectomy than in 20-gauge vitrectomy.
authors: Department of Ophthalmology, Kagoshima City Hospital, Kagoshima, Japan.
authors: Tetsuro
authors: T
authors: Nakano
authors: Akinori
authors: A
authors: Uemura
authors: Taiji
authors: T
authors: Sakamoto