Comparative study of the short - term results of 27 - gauge versus 25 - gauge microincision vitrectomy for vitreoretinal diseases
10.3980/j.issn.1672-5123.2018.7.20
- VernacularTitle:27G与25G微创玻璃体切除术术后短期指标对比分析
- Author:
Jie LI
1
;
San-Mei LIU
;
Fang LI
;
Wen-Tao DONG
;
Jie ZHONG
Author Information
1. 四川省医学科学院·四川省人民医院 电子科技大学医学院附属医院眼科
- Keywords:
27- gauge;
25- gauge;
microincision vitrectomy surgery;
vitreoretinal disease
- From:
International Eye Science
2018;18(7):1252-1256
- CountryChina
- Language:Chinese
-
Abstract:
·AIM:To compare the short-term surgical results of 27-gauge ( 27G ) with 25 - gauge ( 25G ) microincision vitrectomy surgery ( MIVS ) for the treatment of vitreoretinal diseases and evaluate the feasibility, safety and effectiveness of 27G MIVS. · METHODS: Two hundred and seventeen eyes with various vitreoretinal diseases underwent 27G or 25G MIVS from April 2016 to October 2017 and were retrospectively reviewed. One hundred and thirty-five eyes underwent 27G vitrectomy and 82 eyes for 25G vitrectomy. The main outcome measurements of the study included surgical time, intraoperative complications, postoperative ocular inflammation reaction, short-term best corrected visual acuity ( BCVA, LogMAR ) recovery and intraocular pressure fluctuation. ·RESULTS: All surgeries were completed successfully, and no eye in 27G group needed conversion to 25G vitrectomy. The mean surgical times in the 25G group was 56. 4±38. 9 min, which was significant longer than that of 27G group (45. 5 ± 26. 1 min, t= 2. 422, P= 0. 016). However, when comparing the surgical time for each category of disease, there were no significant differences observed (P>0. 05). Within the first week postoperatively, the mean cumulative score of conjunctival congestion, anterior chamber flare and aqueous cell in 25G group were 2.4±1.4, 0.7±1 and 0.5±1, which were higher than those in 27G group (2. 1 ± 1. 6, 0. 3 ± 0. 6, and 0. 2 ± 0. 4), with significant differences (P=0. 038, P=0. 011, P=0. 046 respectively). The improvement of BCVA was-0. 4±0. 9 in 25G group, and -0. 2 ± 0. 9 in the 27G groups respectively (t= -1. 636, P = 0. 103 ). The rate of transient ocular hypotony of the 25G vitrectomy was 19. 5% (16 eyes), which was higher than that of the 27G group without significant difference ( 15. 6% , 21 eyes; χ2= 0. 565, P=0. 452). When the eyes injected with silicone oil were excluded, there was no significant difference in intraocular pressure fluctuation between the 25G group (3. 59±0. 69mmHg) and the 27G group (3. 58±0. 47mmHg;t=0. 007, P=0. 995). ·CONCLUSION: The 27G microincision vitrectomy can be used to treat various vitreoretinal diseases. It is a safe and effective surgical procedure with small incision and mild anterior segment inflammatory reaction.