To compare the intraoperative complications between 23-G and 20-G instrumentation in patients undergoing pars plana vitrectomy (PPV).
This was a retrospective comparative study of 4,274 PPV procedures by the same surgical team between 1998 and 2016. A total of 2,648 operations were carried out with 20-G surgery and 1,626 operations with 23-G surgery. Main outcome measures were the incidence of choroidal haemorrhage, iatrogenic retinal break, and lens touch.
The most frequent surgical indication in both 20-G and 23-G was rhegmatogenous retinal detachment (RRD), 38.7% (1,026/2,648) and 45.9% (746/1,626), respectively. The frequency of choroidal haemorrhage was 1.0% with 20-G surgery (26/2,648) vs 0.6% with 23-G (9/1,626, p = 0.16). Subgroup analysis showed the increased risk was present in RRD surgery, 1.6% (16/1,026) vs 0.1% (1/746, p = 0.002), but not in all other indications combined, 20-G with 0.6% (10/1,622) and 23-G 0.9% (8/88, p = 0.46). This increased risk was also true for RRD when excluding combined scleral buckle surgery. There was an increased risk of iatrogenic retinal break in RRD cases undergoing 20-G, 5.8% (60/1,026), compared to 23-G vitrectomy, 1.9% (14/746, p<0.0001). There was no difference in rates of lens touch between 20-G and 23-G.
23-G microincisional PPV has a lower risk of choroidal haemorrhage and iatrogenic retinal tears than 20-G vitrectomy particularly for eyes with RRD.
Eur J Ophthalmol 2017; 27(2): 226 - 230
Article Type: ORIGINAL RESEARCH ARTICLE
AuthorsJames E. Neffendorf, Bhaskar Gupta, Tom H. Williamson
- • Accepted on 25/07/2016
- • Available online on 09/09/2016
- • Published in print on 10/03/2017
This article is available as full text PDF.
- Neffendorf, James E. [PubMed] [Google Scholar] 1, * Corresponding Author (firstname.lastname@example.org)
- Gupta, Bhaskar [PubMed] [Google Scholar] 1
- Williamson, Tom H. [PubMed] [Google Scholar] 2
Department of Ophthalmology, Royal Berkshire Hospital, Reading - UK
Department of Ophthalmology, St. Thomas’ Hospital, London - UK