PURPOSE: To compare the surgical outcomes of 25-gauge vitrectomy with that of 20-gauge vitrectomy for the repair of retinal detachment complicated with proliferative vitreoretinopathy (PVR). METHODS: Forty-one eyes of 40 patients (17 women, 23 men), who underwent vitrectomy for grade C PVR and had at least 6 months of follow-up period, were investigated retrospectively. The mean age of the patients was 44.6 years (range; 13-78 years). Twenty eyes underwent vitrectomy with a 25-gauge system (25 G Group, including 5 cases with hybrid surgery, i.e., vitrectomy conducted mostly with a 25-gauge and partially with 20-gauge instruments) and 21 eyes had vitrectomy with a 20-gauge system(20 G Group). The intraoperative technique used for vitreous surgery, the number of vitrectomy procedures, the length of the surgery, the surgical success rate, the best-corrected visual acuity (BCVA) and intraocular pressure (IOP) both before and after the vitrectomy were compared between the two groups. RESULTS: There was no significant difference in preoperative background between the two groups. The number patients with inner limiting membrane peeling was significantly higher in the 25 G Group than in the 20 G Group (p = 0.020). There were no significant differences in the number of vitrectomies, surgical time and the rate of retinal reattachment between the two groups (25 G Group; 95.0%, 20 G Group; 85.7%). The BCVAs 6 months after the surgery were significantly better than preoperative BCVAs in both 25 G (p < 0.001) and 20 G Group (p = 0.003). In the 25 G Group, the BCVA was significantly improved 1, 3, and 6 month(s) after the surgery compared to before surgery (p < 0.05), while, in the 20 G Group, the BCVA was significantly improved 3 and 6 months after the surgery (p < 0.05). In addition, the BCVA 6 months after the surgery was significantly (p = 0.010) better in the 25 G Group than in the 20 G Group. There was no significant difference in either the pre- or the postoperative IOP between the two groups, while the rate of the cases with hypotony of less than 5 mmHg was significantly higher (p = 0.048) in the 20 G Group than in the 25 G Group. CONCLUSIONS: These results suggest that, although vitrectomy only with 25-gauge system proved insufficient, 25-gauge vitrectomy may achieve the surgical outcomes for the repair of retinal detachment complicated with PVR equal to or higher than 20-gauge vitrectomy.
PURPOSE: To compare the surgical outcomes of 25-gauge vitrectomy with that of 20-gauge vitrectomy for the repair of retinal detachment complicated with proliferative vitreoretinopathy (PVR). METHODS: Forty-one eyes of 40 patients (17 women, 23 men), who underwent vitrectomy for grade C PVR and had at least 6 months of follow-up period, were investigated retrospectively. The mean age of the patients was 44.6 years (range; 13-78 years). Twenty eyes underwent vitrectomy with a 25-gauge system (25 G Group, including 5 cases with hybrid surgery, i.e., vitrectomy conducted mostly with a 25-gauge and partially with 20-gauge instruments) and 21 eyes had vitrectomy with a 20-gauge system(20 G Group). The intraoperative technique used for vitreous surgery, the number of vitrectomy procedures, the length of the surgery, the surgical success rate, the best-corrected visual acuity (BCVA) and intraocular pressure (IOP) both before and after the vitrectomy were compared between the two groups. RESULTS: There was no significant difference in preoperative background between the two groups. The number patients with inner limiting membrane peeling was significantly higher in the 25 G Group than in the 20 G Group (p = 0.020). There were no significant differences in the number of vitrectomies, surgical time and the rate of retinal reattachment between the two groups (25 G Group; 95.0%, 20 G Group; 85.7%). The BCVAs 6 months after the surgery were significantly better than preoperative BCVAs in both 25 G (p < 0.001) and 20 G Group (p = 0.003). In the 25 G Group, the BCVA was significantly improved 1, 3, and 6 month(s) after the surgery compared to before surgery (p < 0.05), while, in the 20 G Group, the BCVA was significantly improved 3 and 6 months after the surgery (p < 0.05). In addition, the BCVA 6 months after the surgery was significantly (p = 0.010) better in the 25 G Group than in the 20 G Group. There was no significant difference in either the pre- or the postoperative IOP between the two groups, while the rate of the cases with hypotony of less than 5 mmHg was significantly higher (p = 0.048) in the 20 G Group than in the 25 G Group. CONCLUSIONS: These results suggest that, although vitrectomy only with 25-gauge system proved insufficient, 25-gauge vitrectomy may achieve the surgical outcomes for the repair of retinal detachment complicated with PVR equal to or higher than 20-gauge vitrectomy.