Poster Mehmet Onen

Purpose:

To compare anatomical and functional outcomes of 25 gauge and 23 gauge transconjunctival sutureless vitrectomy (TSV) for treatment of proliferative diabetic retinopathy (PDR).

Methods:

Retrospective review of 81 consecutive eyes from 81 patients undergoing 25 gauge and 23 gauge TSV with a minimum of 6-month follow-up (vitreous hemorrhage (VH), n=51; tractional retinal detachment (TRD), n=30). Vitrectomy was performed with ultrahigh-speed (5000cps) 25+ gauge and 23 gauge system, duty cycle control and intraocular pressure control. Thirty-eight patients underwent 25 gauge and 41 patients underwent 23 gauge. Variables and outcomes measures included visual acuity (VA), final anatomical success rate, postoperative intraocular pressure, and surgical complications.

Results:

Preoperative characteristics were similar in both groups. Mean preoperative VA of 1.6 ±0.3 improved to 0.7 ±0.4 in patients of VH at last visit (p=0.0001) while VA did not improve in TRD (p=0.82). The visual acuity at the last visit was 0.8 ±0.52 versus 0.7 ±0.44 in the 25 gauge and 23 gauge, respectively (P =0.25). Anatomic success rate was 93% in patients of TRD. Transient hypotony was detected in 8 eyes (9%) with spontaneous resolution. One patient (3%) in 25 gauge and three patients (10%) in 23 gauge had intraoperative iatrogenic retinal breaks in patients of TRD. One patient (2%) had postoperative upper quadrant of retinal detachment. The incidence of complications was not statistically significant between the two groups. During fibrovascular membrane removal, 25 gauge had an opportunity of lower numbers of vitreoretinal instrument usage instead of 23 gauge.

Conclusion:

Outcomes of 25 gauge versus 23 gauge TSV for management of PDR were not significantly different. Fibrovascular membrane delamination and removal is more effective and safe with 25 gauge vitreous cutter than 23 gauge vitreous cutter.