title: Iatrogenic retinal breaks in 25-gauge vitrectomy under air compared with the standard 25-gauge system for macular diseases.
abstract: OBJECTIVE
  To evaluate the incidence rates of iatrogenic retinal breaks in eyes that underwent 25-gauge vitrectomy under air compared with 25-gauge standard vitrectomy for idiopathic macular holes or idiopathic epiretinal membranes.
  
  
  METHODS
  In this retrospective, comparative interventional study, 435 eyes were enrolled. In all patients after core vitrectomy and epiretinal/inner limiting membrane peeling, complete vitrectomy of the base was performed, respectively under air (air group) or under fluid infusion (standard group).
  
  
  RESULTS
  The number of eyes with iatrogenic retinal breaks was significantly lower in the air group than in standard group (4/197 and 16/238, 2% and 7%, respectively; P = 0.035). A postoperative retinal detachment developed in 2 eyes (1%) in the standard group, and in no eyes of the air group (0%). Factors related to the occurrence of retinal breaks were surgically induced posterior vitreous detachment (P = 0.006), standard vitrectomy (P = 0.023), and surgery for macular hole (P = 0.030).
  
  
  CONCLUSIONS
  The 25-gauge vitrectomy under air is associated with a lower incidence rate of retinal breaks compared with the standard 25-gauge vitrectomy.
authors.affiliation: *Department of Ophthalmology, University of Catania, Catania, Italy; †Department of Ophthalmology, Santa Chiara Hospital, Pisa, Italy; and ‡Department of Ophthalmology, University of Ancona, Ancona, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Reibaldi
authors.forename: Stanislao
authors.initials: S
authors.lastname: Rizzo
authors.forename: Teresio
authors.initials: T
authors.lastname: Avitabile
authors.forename: Antonio
authors.initials: A
authors.lastname: Longo
authors.forename: Mario D
authors.initials: MD
authors.lastname: Toro
authors.forename: Francesca
authors.initials: F
authors.lastname: Viti
authors.forename: Andrea
authors.initials: A
authors.lastname: Saitta
authors.forename: Alfonso
authors.initials: A
authors.lastname: Giovannini
authors.forename: Cesare
authors.initials: C
authors.lastname: Mariotti
mesh_terms: D000368:Aged; D000388:Air; D001485:Basement Membrane / Q000601:surgery; D019773:Epiretinal Membrane / Q000601:surgery*; D005260:Female; D006801:Humans; D007049:Iatrogenic Disease / Q000453:epidemiology; D015994:Incidence; D007431:Intraoperative Complications; D008297:Male; D011183:Postoperative Complications; D012167:Retinal Perforations / Q000453:epidemiology* / Q000601:surgery; D012189:Retrospective Studies; D014821:Vitrectomy / Q000379:methods*