Cesare Forlini (Ravenna, Italy), Matteo Forlini (Modena, Italy), Adriana Bratu (Ravenna, Italy), Paolo Rossini (Ravenna, Italy)


To examine whether 25 Gauge vitrectomy might be a good approach for treatment of severe proliferative diabetic retinopathy (PDR) and macular edema.


31 patients with severe PDR and macular edema were randomized to either 20 or 25 Gauge vitrectomy. The 25 Gauge vitrectomy was performed with bimanual technique, 27 Gauge chandelier illumination, Tano diamond dusted scraper. 16 patients underwent 25 Gauge vitrectomy.

Effectiveness / Safety:

Incidences of complications like iatrogenic retinal tears and bleeding were significantly less in the 25 Gauge vitrectomy group when compared to the 20 Gauge vitrectomy group. The efficacy between the two techniques was similar. The 25 Gauge vitrector was used to cut fibrinous tissue with high accuracy and was found to replace well-curved scissors usually used with the 20 Gauge technique.

Take home message:

25 Gauge vitrectomy might represent the gold standard for treatment of severe PDR and macular edema.