title: 23- vs 20-gauge pars plana vitrectomy in combination with bimanual microincisional cataract surgery (b-MICS) for the treatment of macular hole and cataract as a one-step procedure.
abstract: OBJECTIVE
  23-gauge pars plana vitrectomy (ppv) is a new method for vitreo-retinal surgery. It may reduce operation time, the risk of complications, and patient discomfort, especially in combination with simultaneous bimanual microincisional cataract surgery (b-MICS).
  
  
  METHODS
  Seventy-five consecutive patients who underwent combined cataract surgery and ppv at our center between 1 January 2008 and 31 December 2010 were included. The first 36 patients were treated with 20-gauge ppv, the following 39 patients with 23-gauge ppv. Study end points 8 weeks after surgery were duration of the procedure, improvement of visual acuity, and occurrence of complications.
  
  
  RESULTS
  Duration of surgery was reduced in 23- vs 20-gauge ppv (54.0 ± 11.6 vs 61.0 ± 19.0 min, P=0.08). Visual acuity improved significantly in both the groups (20-gauge: logMAR 0.750 ± 0.304 before and 0.369 ± 0.273 after surgery; 23-gauge: logMAR 0.663 ± 0.340 before and 0.339 ± 0.273 after surgery). There were no appreciable group differences in baseline or post-treatment visual acuity.
  
  
  CONCLUSIONS
  23-gauge ppv in combination with b-MICS is a suitable, safe, and effective method for the treatment of combined cataract and vitreo-retinal diseases. The procedure is somewhat shorter and patient discomfort during and after surgery is improved. In terms of efficacy and safety, 23-gauge ppv is equivalent with conventional 20-gauge ppv.
authors.affiliation: Augenklinik Herzog Carl Theodor, München, Germany. cb.schoenfeld@gmx.net
authors.forename: C-L
authors.initials: CL
authors.lastname: Schönfeld
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002387:Cataract Extraction / Q000379:methods*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008866:Microsurgery / Q000379:methods*; D011183:Postoperative Complications; D012167:Retinal Perforations / Q000601:surgery*; D013536:Suture Techniques; D014792:Visual Acuity; D014821:Vitrectomy / Q000295:instrumentation* / Q000379:methods