Surgical outcomes of 25-gauge transconjunctival vitrectomy combined with cataract surgery for vitreoretinal diseases.
- Author:
Yusuke OSHIMA
1
;
Masahito OHJI
;
Yasuo TANO
Author Information
- Publication Type:Journal Article
- MeSH: Aged; Female; Humans; Lens Implantation, Intraocular; Male; Middle Aged; Phacoemulsification; Retinal Diseases; complications; surgery; Treatment Outcome; Vitrectomy; methods; Vitreous Hemorrhage; complications; surgery
- From:Annals of the Academy of Medicine, Singapore 2006;35(3):175-180
- CountrySingapore
- Language:English
-
Abstract:
INTRODUCTIONTo report surgical outcomes of 25-gauge transconjunctival vitrectomy combined with cataract surgery for the management of a variety of vitreoretinal diseases.
MATERIALS AND METHODSA retrospective, interventional case study was conducted. Chart review of a consecutive series of 150 eyes of 144 patients who underwent 25-gauge vitrectomy combined with phacoemulsification and intraocular lens implantation for epiretinal membrane (n = 62), refractory macular oedema associated with retinal vascular disorders (n = 29), idiopathic macular hole (n = 21), non-clearing vitreous haemorrhage (n = 18), rhegmatogenous retinal detachment (n = 11), tractional retinal detachment associated with proliferative diabetic retinopathy (n = 7), and subretinal haemorrhage (n = 2). Main outcome measures included preand postoperative visual acuity, operating time, intraocular pressure, intra- and postoperative complications.
RESULTSThe mean follow-up period was 9.7 months (range, 6 to 26). The mean overall visual acuity improved from 20/100 preoperatively to 20/38 at final visit (P <0.001). Statistically significant improvement of visual acuity was also observed in each subgroup. Operative time was shortened in macular surgery. No intraoperative complications were noted attributable to small-gauge instruments and no cases required conversion to 20-gauge standard instrumentation. However, 12 eyes (8%) required suture placement to at least one sclerotomy site. Postoperative intraocular pressure remained stable in most cases except 18 eyes (13%) with transient hypotony during the first week after surgery. One case of retinal detachment but no case of endophthalmitis was observed throughout the follow-up period.
CONCLUSIONS25-gauge vitrectomy combined with cataract surgery is a safe and effective system for the management of a variety of vitreoretinal diseases, especially cases requiring minimal intraocular manipulation. Further study is recommended to evaluate potential postoperative complications.