title: Outcomes of 27 Gauge Microincision Vitrectomy Surgery for Posterior Segment Disease.
abstract: OBJECTIVE
  To report the initial experience, clinical outcomes, and safety profile of 27 gauge pars plana vitrectomy (PPV) in eyes with posterior segment disease.
  
  
  METHODS
  Multicenter, retrospective, interventional case series.
  
  
  METHODS
  setting: Private practice and tertiary care settings.
  
  
  METHODS
  Eyes undergoing 27 gauge PPV for a vitreoretinal surgery indication.
  
  
  METHODS
  Three-port, transconjunctival 27 gauge PPV.
  
  
  METHODS
  Change in visual acuity and occurrence of intraoperative and postoperative complications with minimum follow-up of 90 days.
  
  
  RESULTS
  Ninety-five eyes met the inclusion criteria. Surgical indications included epiretinal membrane (n = 26), diabetic tractional retinal detachment (n = 14), full-thickness macular hole (n = 11), rhegmatogenous retinal detachment with (n = 7) or without (n = 9) proliferative vitreoretinopathy (PVR), vitreous hemorrhage (n = 10), vitreous opacities (n = 8), endophthalmitis (n = 4), sub-silicone oil retinal detachment (n = 3), retained lens material (n = 1), submacular hemorrhage (n = 1), and aqueous misdirection (n = 1). Mean logMAR visual acuity improved from 1.08 ± 0.71 (20/240 Snellen equivalent) preoperatively to 0.53 ± 0.65 (20/67 Snellen equivalent) postoperatively (P < .001). Mean follow-up was 144 days (median 127 days, range 90-254 days). There were no intraoperative complications and no case required conversion to 20, 23, or 25 gauge instrumentation. A total of 3 sclerotomy sites (1.1%) were sutured at the conclusion of surgery. Postoperative complications included transient ocular hypertension in 8 eyes (8.4%), transient hypotony in 5 eyes (5.3%), and vitreous hemorrhage in 5 eyes (5.3%). No cases of postoperative endophthalmitis, sclerotomy-related retinal tears, or choroidal detachments were encountered in the follow-up period.
  
  
  CONCLUSIONS
  The 27 gauge PPV was well tolerated with low rates of intraoperative and postoperative complications across varied surgical indications.
authors.affiliation: Wills Eye Hospital, Philadelphia, Pennsylvania.
authors.forename: M Ali
authors.initials: MA
authors.lastname: Khan
authors.affiliation: Wills Eye Hospital, Philadelphia, Pennsylvania.
authors.forename: Abtin
authors.initials: A
authors.lastname: Shahlaee
authors.affiliation: Cincinnati Eye Institute and University of Cincinnati, Cincinnati, Ohio.
authors.forename: Brian
authors.initials: B
authors.lastname: Toussaint
authors.affiliation: Wills Eye Hospital, Philadelphia, Pennsylvania.
authors.forename: Jason
authors.initials: J
authors.lastname: Hsu
authors.affiliation: Wills Eye Hospital, Philadelphia, Pennsylvania.
authors.forename: Arunan
authors.initials: A
authors.lastname: Sivalingam
authors.affiliation: Retina Consultants of Arizona, Phoenix, Arizona; University of Southern California (USC) Eye Institute, Keck School of Medicine, Los Angeles, California.
authors.forename: Pravin U
authors.initials: PU
authors.lastname: Dugel
authors.affiliation: Eye Consultants of Maryland, Owings Mills, Maryland.
authors.forename: Rohit R
authors.initials: RR
authors.lastname: Lakhanpal
authors.affiliation: Cincinnati Eye Institute and University of Cincinnati, Cincinnati, Ohio.
authors.forename: Christopher D
authors.initials: CD
authors.lastname: Riemann
authors.affiliation: Berrocal & Associates, San Juan, Puerto Rico.
authors.forename: Maria H
authors.initials: MH
authors.lastname: Berrocal
authors.affiliation: Wills Eye Hospital, Philadelphia, Pennsylvania.
authors.forename: Carl D
authors.initials: CD
authors.lastname: Regillo
authors.affiliation: Wills Eye Hospital, Philadelphia, Pennsylvania. Electronic address: acho@midatlanticretina.com.
authors.forename: Allen C
authors.initials: AC
authors.lastname: Ho
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005128:Eye Diseases / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008866:Microsurgery / Q000379:methods*; D008875:Middle Aged; D011183:Postoperative Complications; D012164:Retinal Diseases / Q000503:physiopathology / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy / Q000379:methods*; D057586:Vitreoretinal Surgery; D014822:Vitreous Body / Q000503:physiopathology / Q000601:surgery*