Faster recovery after 25-gauge microincision vitrectomy surgery than after 20-gauge vitrectomy in patients with proliferative diabetic retinopathy

Abstract

Background and methods: We compared surgical procedures and outcomes, including duration of recovery period, in eyes with proliferative diabetic retinopathy that underwent 25-gauge microincision vitrectomy surgery with those that underwent 20-gauge vitrectomy. Seventy-two eyes from 53 patients that underwent 20-gauge vitrectomy in 2006 and 87 eyes from 55 patients that underwent 25-gauge vitrectomy in 2010 were studied. The surgical procedures, ie, number of vitreous procedures, operating time, and ratio of type of intraocular tamponade were compared between the two groups. In addition, the outcomes, ie, postoperative complications, anatomical success, postoperative best-corrected visual acuity (BCVA), and duration of hospitalization as an indicator of the postoperative recovery period were also compared.

Results: There were no significant differences in surgical procedures or ratio of cases with postoperative complications between cases with 20-gauge and 25-gauge vitrectomy. The final anatomical success rate was 100% in the two groups. BCVA at 6 months after the final vitrectomy was significantly better than the preoperative BCVA for both types of vitrectomy (P < 0.05), and was not significantly different between the two groups. The average duration of hospitalization was 19.5 days after 20-gauge vitrectomy, which was significantly longer than the 11.0 days after 25-gauge vitrectomy (P < 0.001).

Conclusion: These results indicate that the anatomical and functional improvements after 25-gauge microincision vitrectomy surgery are not significantly different from those after 20-gauge vitrectomy in eyes with proliferative diabetic retinopathy. However, the significantly shorter recovery period after 25-gauge microincision vitrectomy surgery suggests that it is less traumatic than 20-gauge vitrectomy.

Keywords: 25-gauge vitrectomy; diabetic retinopathy; microincision vitrectomy surgery; postoperative recovery; vitrectomy.

Figure 1

Perioperative visual acuity. Notes: The abscissa represents time and the ordinate represents best-corrected visual acuity (BCVA) in logarithm of minimum angle resolution (logMAR) units. Statistical analyses were performed by Friedman repeated-measures analysis of variance on ranks, followed by Dunn’s method to detect significant differences between each time point and previtrectomy (*P < 0.05).