Comparison of Efficacy and Safety between Transconjunctival 23-Gauge and Conventional 20-Gauge Vitrectomy Systems in Macular Surgery.
10.3341/kjo.2012.26.5.339
- Author:
Tugba GONCU
1
;
Gokhan GURELIK
;
Berati HASANREISOGLU
Author Information
1. Ophthalmology Department, Nevsehir Goverment Hospital, Nevsehir, Turkey. tubicon@hotmail.com
- Publication Type:Original Article ; Clinical Trial ; Comparative Study
- Keywords:
Epiretinal membrane;
Retinal perforations;
Vitreoretinal surgery
- MeSH:
Aged;
Female;
Humans;
Male;
Middle Aged;
Operative Time;
Postoperative Complications;
Prospective Studies;
Retinal Perforations/*surgery;
Statistics, Nonparametric;
Treatment Outcome;
Visual Acuity;
Vitrectomy/*methods
- From:Korean Journal of Ophthalmology
2012;26(5):339-346
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: To compare the efficacy and safety of 23-gauge transconjunctival vitrectomy with the conventional 20-gauge method in idiopathic epiretinal membrane and macular hole surgery. METHODS: Sixty-one consecutive patients undergoing vitrectomy for idiopathic epiretinal membrane and macular hole were recruited to either 20- or 23-gauge vitrectomy groups and prospectively evaluated. Surgical success rates, operating time, surgery-related complications, long-term visual outcomes, and postoperative ocular surface problems are compared in the two groups. RESULTS: There were 31 eyes in the 20-gauge group and 33 eyes in the 23-gauge group. The macular hole closure rate after the first surgery was 83% and 90.9% in the 20-gauge and 23-gauge groups, respectively, with no significant difference between groups (p = 0.59). The success rate for idiopathic epiretinal membranes cases was 100% in both groups. There was no statistically significant difference between overall surgical times (p = 0.90). None of the patients in either group experienced postoperative complications of severe postoperative hypotony, vitreous hemorrhage or endophthalmitis, except one eye in the 20-gauge group, which was found to have retinal detachment. In both groups, statistically significant improvement in visual acuity was achieved 1-month postoperatively (p = 0.002) and thereafter at all postoperative visits (p < 0.05). The mean ocular surface scores were significantly lower in the 23-gauge group at all postoperative visits compared with the 20-gauge group scores (p = 0.001). CONCLUSIONS: Transconjunctival 23-gauge vitrectomy appears to be as effective and safe as conventional 20-gauge vitrectomy in idiopathic epiretinal membrane and macular hole surgeries.
