Outcomes of Combined 25 Gauge and 20 Gauge Pars Plana Vitrectomy

Acar, Nur; Kapran, Ziya; Altan, Tugrul; Ünver, Yaprak Banu; Yurttaser, Serap
June 2009
Retina-Vitreus/Journal of Retina-Vitreous;Jun2009, Vol. 17 Issue 2, p125
Academic Journal
Purpose: To evaluate the anatomical and functional outcomes of combined 25 gauge and 20 gauge pars plana vitrectomy (PPV) in the treatment of a variety of vitreoretinal diseases. Materials and Methods: In this retrospective interventional case series combined 25 gauge and 20 gauge PPV was performed in 41 eyes. In the combined technique, two 25 g sutureless sclerotomies and one 20 g (for the active hand) sclerotomy were performed. Eyes with a minimum followup of 6 months were evaluated. Main outcome measures were the number of sutures in 25 gauge sclerotomies, changes in visual acuity, intraocular pressure (IOP), and rates of complications. Results: Mean follow-up was 9.34±2.27 months. No suture was necessary for the 25g sclerotomies. Mean visual acuity improved at postoperative month 1 (p=0.002) and at the last visit (p<0.001). A significant decrease in mean IOP was detected after 2 hours (p<0.001) and by day 1 (p=0.001) postoperatively. In one (2.43%) eye transient severe hypotony was observed. In two eyes operated on with a diagnosis of a macular hole, the holes were sealed after a second surgical procedure. Conclusion: Combined 25 g and 20 g PPV for treatment of a variety of vitreoretinal diseases yielded anatomic and functional recovery without significant complications. This technique combines the advantages of both systems, expands the indications of 25 g sutureless vitrectomy, and obviates the need for a variety of 25 g instruments.


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