Outcomes of 27 Gauge Microincision Vitrectomy Surgery for Posterior Segment Disease

Abstract

Purpose: To report the initial experience, clinical outcomes, and safety profile of 27 gauge pars plana vitrectomy (PPV) in eyes with posterior segment disease.

Design: Multicenter, retrospective, interventional case series.

Methods: setting: Private practice and tertiary care settings.

Study population: Eyes undergoing 27 gauge PPV for a vitreoretinal surgery indication.

Intervention: Three-port, transconjunctival 27 gauge PPV.

Main outcome measures: Change in visual acuity and occurrence of intraoperative and postoperative complications with minimum follow-up of 90 days.

Results: Ninety-five eyes met the inclusion criteria. Surgical indications included epiretinal membrane (n = 26), diabetic tractional retinal detachment (n = 14), full-thickness macular hole (n = 11), rhegmatogenous retinal detachment with (n = 7) or without (n = 9) proliferative vitreoretinopathy (PVR), vitreous hemorrhage (n = 10), vitreous opacities (n = 8), endophthalmitis (n = 4), sub-silicone oil retinal detachment (n = 3), retained lens material (n = 1), submacular hemorrhage (n = 1), and aqueous misdirection (n = 1). Mean logMAR visual acuity improved from 1.08 ± 0.71 (20/240 Snellen equivalent) preoperatively to 0.53 ± 0.65 (20/67 Snellen equivalent) postoperatively (P < .001). Mean follow-up was 144 days (median 127 days, range 90-254 days). There were no intraoperative complications and no case required conversion to 20, 23, or 25 gauge instrumentation. A total of 3 sclerotomy sites (1.1%) were sutured at the conclusion of surgery. Postoperative complications included transient ocular hypertension in 8 eyes (8.4%), transient hypotony in 5 eyes (5.3%), and vitreous hemorrhage in 5 eyes (5.3%). No cases of postoperative endophthalmitis, sclerotomy-related retinal tears, or choroidal detachments were encountered in the follow-up period.

Conclusion: The 27 gauge PPV was well tolerated with low rates of intraoperative and postoperative complications across varied surgical indications.