Original article23- and 20-Gauge Vitrectomy with Air Tamponade with Combined Phacoemulsification for Idiopathic Macular Hole: A Single-Surgeon Study
Section snippets
Methods
We retrospectively reviewed 50 eyes of 47 consecutive patients with an idiopathic macular hole who underwent 20-gauge vitrectomy combined with phacoemulsification surgery and 50 eyes of 48 consecutive patients with the disorder who underwent 23-gauge vitrectomy combined with phacoemulsification surgery performed by the same surgeon (T.H.), who was experienced with both vitreous and phacoemulsification surgeries (Table). Twenty-gauge vitrectomies were performed from April 2004 through June 2006,
Results
The Table shows the demographic and baseline characteristics of the eyes in the 2 study groups. No significant differences were found among the preoperative characteristics between the 2 groups.
A posterior vitreous detachment was created during surgery in 38 (76%) eyes in the 23-gauge group and 37 (74%) eyes in the 20-gauge group. Retinal breaks associated with the maneuvers performed to create a posterior vitreous detachment developed in 6 (16%) of 38 eyes and ion 7 (19%) of 37 eyes in the 23-
Discussion
In the current study, less surgically induced corneal astigmatism developed 3 months after surgery in eyes that underwent 23-gauge vitrectomy to repair idiopathic macular holes compared with the eyes treated with 20-gauge vitrectomy. The improvement in the VA 1 and 3 months after surgery was greater, and the VAs 1 and 3 months after surgery were better in the 23-gauge group. However, no significant difference was found in VA 1 year after surgery between the 2 groups.
We previously reported rapid
Taiichi Hikichi, MD, PhD, has been a chief doctor of the ward of Ohtsuka Eye Hospital, Sapporo, Japan, since 2004. He received his MD and PhD from Asahikawa Medical College, Asahikawa, Japan. From 1992 to 1994, Dr Hikichi was a fellow at the Schepens Eye Research Institute, Department of Ophthalmology, Harvard Medical School, and Schepens Retina Associates, Boston, MA. His primary areas of interest are vitreoretinal disorders and vitreous surgery.
References (50)
- et al.
A new 25-gauge instrument system for transconjunctival sutureless vitrectomy surgery
Ophthalmology
(2002) - et al.
Initial experience using the transconjunctival sutureless vitrectomy system for vitreoretinal surgery
Ophthalmology
(2002) Sutureless microincision vitrectomy surgery: unclear benefit, uncertain safety
Am J Ophthalmol
(2007)- et al.
Longer-term outcomes of transconjunctival sutureless 25-gauge vitrectomy
Am J Ophthalmol
(2005) - et al.
Small-gauge pars plana vitrectomy
Ophthalmology
(2010) - et al.
Human autologous serum for the treatment of full-thickness macular holesA preliminary study
Ophthalmology
(1995) Macular hole surgery with and without internal limiting membrane peeling
Ophthalmology
(2000)- et al.
Results of macular hole surgery with and without epiretinal dissection or internal limiting membrane removal
Ophthalmology
(2004) - et al.
Indocyanine green-assisted peeling of the retinal internal limiting membrane
Ophthalmology
(2000) - et al.
Progression of nuclear sclerosis and long-term visual results of vitrectomy with transforming growth factor beta-2 for macular holes
Am J Ophthalmol
(1995)
Combined surgery and sequential surgery comprising phacoemulsification, pars plana vitrectomy, and intraocular lens implantation: comparison of clinical outcomes
J Cataract Refract Surg
Combined pars plana vitrectomy and phacoemulsification to restore visual acuity in patients with chronic uveitis
J Cataract Refract Surg
Combined phacoemulsification, intraocular lens implantation, and vitrectomy for eyes with coexisting cataract and vitreoretinal pathology
Am J Ophthalmol
Idiopathic epiretinal macular membrane and cataract extraction: combined versus consecutive surgery
Am J Ophthalmol
Macular hole surgery and cataract extraction: combined vs consecutive surgery
Am J Ophthalmol
Calculating the surgically induced refractive change following ocular surgery
J Cataract Refract Surg
Comparison of visual function after epiretinal membrane removal by 20-gauge and 25-gauge vitrectomy
Am J Ophthalmol
Long-term corneal astigmatism related to selected elastic, monofilament, nonabsorbable sutures
J Cataract Refract Surg
Effect of suture material on postoperative astigmatism
J Cataract Refract Surg
Phacoemulsification and lens implantation after pars plana vitrectomy
Ophthalmology
Vitreoretinal outpatient surgery: clinical and financial considerations
J Fr Ophtalmol
Sutureless pars plana vitrectomy through self-sealing sclerotomies
Arch Ophthalmol
Transconjunctival sutureless 23-gauge vitrectomy
Retina
Comparison of 1-year outcomes between 23- and 20-gauge vitrectomy for preretinal membrane
Am J Ophthalmol
Outcomes of 77 consecutive cases of 23-gauge transconjunctival vitrectomy surgery for posterior segment disease
Ophthalmology
Cited by (23)
Combining cataract surgery with 25-gauge high-speed pars plana vitrectomy: Results from a retrospective study
2014, OphthalmologyCitation Excerpt :Whether to remove a cataract with phacoemulsification during vitreomacular surgery is a much discussed topic. Hütz et al15 and Hikichi et al16 retrospectively studied this controversy, and they mostly focused their attention on postoperative recovery of visual acuity. They observed that visual acuity improved earlier after combined cataract extraction and vitreomacular surgery with an acceptable safety profile.
The value of combining autofluorescence and optical coherence tomography in predicting the visual prognosis of sealed macular holes
2013, American Journal of OphthalmologyClinical Outcomes of Combined Phacoemulsification With Intraocular Lens Placement and Microincision Vitrectomy in Adult Vitreoretinal Disease
2023, Journal of VitreoRetinal Diseases
Taiichi Hikichi, MD, PhD, has been a chief doctor of the ward of Ohtsuka Eye Hospital, Sapporo, Japan, since 2004. He received his MD and PhD from Asahikawa Medical College, Asahikawa, Japan. From 1992 to 1994, Dr Hikichi was a fellow at the Schepens Eye Research Institute, Department of Ophthalmology, Harvard Medical School, and Schepens Retina Associates, Boston, MA. His primary areas of interest are vitreoretinal disorders and vitreous surgery.