Department of Ophthalmology and Optometry, Medical University Vienna, Vienna, Austria.
Center for Medical Statistics, Informatics and Intelligent Systems, Section for Medical Statistics, Medical University Vienna, Vienna, Austria.
PLoS One. 2021 Mar 5;16(3):e0248164. doi: 10.1371/journal.pone.0248164. eCollection 2021.
To assess and compare safety and effectiveness between 23-gauge and 25-gauge vitrectomy systems for the treatment of common vitreoretinal diseases in non-vitrectomized eyes.
Retrospective evaluation of patients who underwent pars plana vitrectomy from April 2018 to December 2019 at the Department of Ophthalmology and Optometry at the Medical University of Vienna (MUV) for the following indications: macular epiretinal membrane, macular hole, macular lamellar hole, vitreous hemorrhage, vitreous opacities, vitreomacular traction syndrome and macular edema.
201 eyes of 195 patients that underwent 23-gauge (n = 105 eyes) or 25-gauge (n = 96 eyes) vitrectomy were included in this study. The mean best-corrected visual acuity (BCVA) improved at 1-3 months postoperatively and beyond 3 months in both gauge groups. Risk of any complication within 1 month postoperatively was lower in the 25-gauge group, but the difference was statistically not significant (HR [95% CI]: 0.95 [0.53; 1.70], p = 0.85). Intraocular pressure less than 5 mmHg was observed in 2 eyes (2%) in the 23-gauge group at the first postoperative day. Intraocular pressure elevation over 25 mmHg occurred in 5 eyes (2 eyes, 2%, in 23-gauge and 3 eyes, 3%, in 25-gauge group) at postoperative day 1, between 7 and 28 days in 5 cases (2 eyes, 2%, in 23-gauge and 3 eyes, 3%, in 25-gauge group), and in 2 eyes (2%) of the 23-gauge group at postoperative day 145 and 61, respectively. Retinal detachment occurred in 1 eye (1%) in the 23-gauge and in 3 eyes (3%) in the 25-gauge group. We did not observe any cases of endophthalmitis.
Results in terms of safety, surgical success and visual outcomes for the treatment of common vitreoretinal surgery indications seem to be comparable between 23-gauge and 25-gauge vitrectomy systems, indicating that the two gauge systems can be used equally in the clinical routine.
评估和比较 23G 和 25G 玻璃体切割系统治疗非玻璃体切割眼常见玻璃体视网膜疾病的安全性和有效性。
回顾性评估 2018 年 4 月至 2019 年 12 月在维也纳医科大学眼科和验光科接受经睫状体平坦部玻璃体切除术的患者，适应证如下：黄斑视网膜前膜、黄斑裂孔、黄斑板层裂孔、玻璃体出血、玻璃体混浊、玻璃体黄斑牵拉综合征和黄斑水肿。
本研究纳入了 23G（n=105 眼）或 25G（n=96 眼）玻璃体切割术的 195 例患者的 201 只眼。两组术后 1-3 个月及以后最佳矫正视力（BCVA）均有改善。术后 1 个月内任何并发症的风险在 25G 组较低，但差异无统计学意义（HR[95%CI]：0.95[0.53；1.70]，p=0.85）。术后第 1 天，23G 组有 2 只眼（2%）眼压低于 5mmHg。术后第 1 天，25G 组有 5 只眼（2 只眼，2%，23G 和 3 只眼，3%，25G）眼压升高超过 25mmHg，7-28 天 5 例（2 只眼，2%，23G 和 3 只眼，3%，25G），术后第 145 和 61 天，23G 组各有 2 只眼（2%）眼压升高。23G 组 1 只眼（1%）发生视网膜脱离，25G 组 3 只眼（3%）发生视网膜脱离。我们没有观察到任何眼内炎病例。
在治疗常见玻璃体视网膜手术适应证方面，23G 和 25G 玻璃体切割系统的安全性、手术成功率和视力结果似乎相当，表明这两种计测系统在临床常规中可以同等使用。
