Comparison of efficacy and safety between transconjunctival 23-gauge and conventional 20-gauge vitrectomy systems in macular surgery.
OBJECTIVE
To compare the efficacy and safety of 23-gauge transconjunctival vitrectomy with the conventional 20-gauge method in idiopathic epiretinal membrane and macular hole surgery.


METHODS
Sixty-one consecutive patients undergoing vitrectomy for idiopathic epiretinal membrane and macular hole were recruited to either 20- or 23-gauge vitrectomy groups and prospectively evaluated. Surgical success rates, operating time, surgery-related complications, long-term visual outcomes, and postoperative ocular surface problems are compared in the two groups.


RESULTS
There were 31 eyes in the 20-gauge group and 33 eyes in the 23-gauge group. The macular hole closure rate after the first surgery was 83% and 90.9% in the 20-gauge and 23-gauge groups, respectively, with no significant difference between groups (p = 0.59). The success rate for idiopathic epiretinal membranes cases was 100% in both groups. There was no statistically significant difference between overall surgical times (p = 0.90). None of the patients in either group experienced postoperative complications of severe postoperative hypotony, vitreous hemorrhage or endophthalmitis, except one eye in the 20-gauge group, which was found to have retinal detachment. In both groups, statistically significant improvement in visual acuity was achieved 1-month postoperatively (p = 0.002) and thereafter at all postoperative visits (p < 0.05). The mean ocular surface scores were significantly lower in the 23-gauge group at all postoperative visits compared with the 20-gauge group scores (p = 0.001).


CONCLUSIONS
Transconjunctival 23-gauge vitrectomy appears to be as effective and safe as conventional 20-gauge vitrectomy in idiopathic epiretinal membrane and macular hole surgeries.
Ophthalmology Department, Nevsehir Goverment Hospital, Nevsehir, Turkey. tubicon@hotmail.com
Tugba
T
Goncu
Gokhan
G
Gurelik
Berati
B
Hasanreisoglu
D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011183:Postoperative Complications; D011446:Prospective Studies; D012167:Retinal Perforations / Q000601:surgery*; D018709:Statistics, Nonparametric; D016896:Treatment Outcome; D014792:Visual Acuity; D014821:Vitrectomy / Q000379:methods*