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Erschienen in: Spektrum der Augenheilkunde 3/2012

01.06.2012 | short review

23-gauge versus 20-gauge vitrectomy: analysis of 110 consecutive cases undergoing epiretinal membrane peeling and macular hole repair

verfasst von: Martina C. Herwig, MD, Nicole Eter, MD

Erschienen in: Spektrum der Augenheilkunde | Ausgabe 3/2012

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Summary

Purpose 23G vitrectomy is a new approach towards minimal invasive vitreoretinal surgery. However, many concerns have been raised related to its safety. A case-to-case comparison with 20G vitrectomy, therefore, appears prudent.
Methods Our first 55 consecutive cases treated with 23G vitrectomy for epiretinal membrane peeling and macular hole repair were compared to 55 matching patients treated with 20G vitrectomy.
Results Patients who underwent 23G surgery had a statistically significant shorter procedure time than the 20G vitrectomy group (20G: 46±15 min; 23G: 33±09 min). We found no higher incidence of endophthalmitis, severe enduring postoperative hypotony, or retinal detachment in the 23G group.
Conclusion 23G vitrectomy is time-saving compared to 20G vitrectomy while being equally safe. Thus, 23G vitrectomy is recommended as standard procedure for epiretinal membrane peeling and macular hole repair.
Literatur
1.
Zurück zum Zitat Fine HF, Iranmanesh R, Iturralde D, Spaide RF. Outcomes of 77 consecutive cases of 23-gauge transconjunctival vitrectomy surgery for posterior segment disease. Ophthalmology. 2007;114:1197–200.PubMedCrossRef Fine HF, Iranmanesh R, Iturralde D, Spaide RF. Outcomes of 77 consecutive cases of 23-gauge transconjunctival vitrectomy surgery for posterior segment disease. Ophthalmology. 2007;114:1197–200.PubMedCrossRef
2.
Zurück zum Zitat Wimpissinger B, Kellner L, Brannath W, et al. 23-Gauge versus 20-gauge system for pars plana vitrectomy: a prospective randomised clinical trial. Br J Ophthalmol. 2008;92:1483–7.PubMedCrossRef Wimpissinger B, Kellner L, Brannath W, et al. 23-Gauge versus 20-gauge system for pars plana vitrectomy: a prospective randomised clinical trial. Br J Ophthalmol. 2008;92:1483–7.PubMedCrossRef
3.
Zurück zum Zitat Hikichi T, Kosaka S, Takami K, et al. 23- and 20-gauge vitrectomy with air tamponade with combined phacoemulsification for idiopathic macular hole: a single-surgeon study. Am J Ophthalmol. 2011;152:114–21.PubMedCrossRef Hikichi T, Kosaka S, Takami K, et al. 23- and 20-gauge vitrectomy with air tamponade with combined phacoemulsification for idiopathic macular hole: a single-surgeon study. Am J Ophthalmol. 2011;152:114–21.PubMedCrossRef
4.
Zurück zum Zitat Hikichi T, Matsumoto N, Ohtsuka H, et al. Comparison of one-year outcomes between 23- and 20-gauge vitrectomy for preretinal membrane. Am J Ophthalmol. 2009;147:639–43.PubMedCrossRef Hikichi T, Matsumoto N, Ohtsuka H, et al. Comparison of one-year outcomes between 23- and 20-gauge vitrectomy for preretinal membrane. Am J Ophthalmol. 2009;147:639–43.PubMedCrossRef
5.
Zurück zum Zitat Nagpal M, Wartikar S, Nagpal K. Comparison of clinical outcomes and wound dynamics of sclerotomy ports of 20, 25, and 23 gauge vitrectomy. Retina. 2009;29:225–31.PubMedCrossRef Nagpal M, Wartikar S, Nagpal K. Comparison of clinical outcomes and wound dynamics of sclerotomy ports of 20, 25, and 23 gauge vitrectomy. Retina. 2009;29:225–31.PubMedCrossRef
6.
7.
Zurück zum Zitat Woo SJ, Park KH, Hwang JM, Kim JH, Yu YS, Chung H. Risk factors associated with sclerotomy leakage and postoperative hypotony after 23-gauge transconjunctival sutureless vitrectomy. Retina. 2009;29:456–63.PubMedCrossRef Woo SJ, Park KH, Hwang JM, Kim JH, Yu YS, Chung H. Risk factors associated with sclerotomy leakage and postoperative hypotony after 23-gauge transconjunctival sutureless vitrectomy. Retina. 2009;29:456–63.PubMedCrossRef
8.
Zurück zum Zitat Kunimoto DY, Kaiser RS. Incidence of endophthalmitis after 20- and 25-gauge vitrectomy. Ophthalmology. 2007;114:2133–7.PubMedCrossRef Kunimoto DY, Kaiser RS. Incidence of endophthalmitis after 20- and 25-gauge vitrectomy. Ophthalmology. 2007;114:2133–7.PubMedCrossRef
9.
Zurück zum Zitat Scott IU, Flynn HW Jr, Acar N, Dev S, Shaikh S, Mittra RA, et al. Incidence of endophthalmitis after 20-gauge vs 23-gauge vs 25-gauge pars plana vitrectomy. Graefes Arch Clin Exp Ophthalmol. 2011;249:377–80.PubMedCrossRef Scott IU, Flynn HW Jr, Acar N, Dev S, Shaikh S, Mittra RA, et al. Incidence of endophthalmitis after 20-gauge vs 23-gauge vs 25-gauge pars plana vitrectomy. Graefes Arch Clin Exp Ophthalmol. 2011;249:377–80.PubMedCrossRef
10.
Zurück zum Zitat Thompson JT. Advantages and limitations of small gauge vitrectomy. Surv Ophthalmol. 2011;56:162–72.PubMedCrossRef Thompson JT. Advantages and limitations of small gauge vitrectomy. Surv Ophthalmol. 2011;56:162–72.PubMedCrossRef
11.
Zurück zum Zitat Heimann H. Primary 25- and 23-gauge vitrectomy in the treatment of rhegmatogenous retinal detachment–advancement of surgical technique or erroneous trend? Klin Monatsbl Augenheilkd. 2008;225:947–56.PubMedCrossRef Heimann H. Primary 25- and 23-gauge vitrectomy in the treatment of rhegmatogenous retinal detachment–advancement of surgical technique or erroneous trend? Klin Monatsbl Augenheilkd. 2008;225:947–56.PubMedCrossRef
Metadaten
Titel
23-gauge versus 20-gauge vitrectomy: analysis of 110 consecutive cases undergoing epiretinal membrane peeling and macular hole repair
verfasst von
Martina C. Herwig, MD
Nicole Eter, MD
Publikationsdatum
01.06.2012
Verlag
Springer Vienna
Erschienen in
Spektrum der Augenheilkunde / Ausgabe 3/2012
Print ISSN: 0930-4282
Elektronische ISSN: 1613-7523
DOI
https://doi.org/10.1007/s00717-012-0104-y

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