title: Efficacy of higher cutting rates during microincision vitrectomy for proliferative diabetic retinopathy.
abstract: OBJECTIVE
  To compare the outcomes of 25-G vitrectomy using a vitreous cutter with a higher cutting rate to that of conventional 25-G vitrectomy with a lower cutting rate on eyes with severe proliferative diabetic retinopathy (PDR).
  
  
  METHODS
  The medical records of 393 eyes of 326 patients with severe PDR were reviewed. A higher cutting rate dual-pneumatic 25-G vitrectomy probe (5,000 cuts/min, Constellation) was used on 219 eyes (group C) and a conventional 25-G pneumatic vitrectomy probe with lower cutting rate was used on 174 eyes (2,500 or 1,500 cuts/min, Acurrus) (group A). The visual and anatomical outcomes and the incidences of intraoperative and postoperative complications were compared.
  
  
  RESULTS
  The incidence of combined cataract surgery was significantly higher in group C (p&lt;0.001). The number of eyes in which scissors were used was significantly lower in group C (p&lt;0.001), and the use of perfluorocarbon liquid was higher in group C (p = 0.015). The incidence of intraoperative iatrogenic tears, postoperative retinal detachments, and neovascular glaucoma was not significantly different between the 2 groups, but the incidence of postoperative vitreous hemorrhage was significantly lower in group C eyes (p&lt;0.001). Preoperative and postoperative vision were not significantly different between the 2 groups.
  
  
  CONCLUSIONS
  The higher vitreous cutting rates during 25-G vitrectomy make it easier to dissect fibrovascular membranes with only the vitreous cutter, and achieved equivalent anatomical and visual outcomes after 25-G vitrectomy for PDR.
authors.affiliation: Kyorin Eye Center, Kyorin University School of Medicine, Tokyo - Japan.
authors.forename: Masahiko
authors.initials: M
authors.lastname: Sano
authors.affiliation: Kyorin Eye Center, Kyorin University School of Medicine, Tokyo - Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Inoue
authors.affiliation: Kyorin Eye Center, Kyorin University School of Medicine, Tokyo - Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Itoh
authors.affiliation: Kyorin Eye Center, Kyorin University School of Medicine, Tokyo - Japan.
authors.forename: Kazunari
authors.initials: K
authors.lastname: Hirota
authors.affiliation: Kyorin Eye Center, Kyorin University School of Medicine, Tokyo - Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Koto
authors.affiliation: Kyorin Eye Center, Kyorin University School of Medicine, Tokyo - Japan.
authors.forename: Akito
authors.initials: A
authors.lastname: Hirakata
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003930:Diabetic Retinopathy / Q000601:surgery*; D005260:Female; D006801:Humans; D007431:Intraoperative Complications; D008297:Male; D008866:Microsurgery / Q000379:methods; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy / Q000295:instrumentation / Q000379:methods*; D014822:Vitreous Body / Q000601:surgery*; D055815:Young Adult