Comparison of 25- and 23-gauge sutureless microincision vitrectomy surgery in the treatment of various vitreoretinal diseases

Abstract

Purpose: To compare the effectiveness and safety of 25- and 23-gauge sutureless microincision vitrectomy surgery (MIVS) in the management of various vitreoretinal diseases.

Methods: Eighty-five consecutive patients undergoing sutureless vitrectomy during January to April 2008 were randomized to either 25- or 23-gauge MIVS. Data collected prospectively included best-corrected visual acuity (BCVA), operation time, postoperative visual recovery, postoperative anterior segment change, and complications.

Results: The most common indications for MIVS were macular hole, macular pucker, vitreous haemorrhage, and diabetic traction retinal detachment. Mean operation times of the 25-gauge (n=38) and 23-gauge groups (n=47) were 33.68 and 34.47 min, respectively (P=0.942). Mean BCVA improved significantly in both the 25- and 23-gauge groups when measured 3-month postoperatively. There was no between-group difference in either the degree or the rate of postoperative visual recovery. Seven patients in the 23-gauge group, compared with three in the 25-gauge group, required suturing of sclerotomy at the end of the surgery. No patients in either group developed postoperative wound leakage or endophthalmitis.

Conclusion: Our prospective study suggests that, within the limited indications, both 25- and 23-gauge MIVS are equally effective, with similar safety profiles. Gauge selection thus may be made according to a surgeon's preference and the availability of appropriate instruments.