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Mueller, T.
Comparison of 27-gauge vs 23-gauge vitrectomy in epiretinal membrane surgery
Humanmedizin; [ Diplomarbeit ] Medizinische Universität Graz; 2022. pp. 47 [OPEN ACCESS]
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Authors Med Uni Graz:
Advisor:: Seidel Gerald
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Abstract:: Introduction Small incision pars plana vitrectomy is the standard of care for epiretinal membranes. As the instruments and their lumina have been becoming smaller trade-offs between minimal invasiveness and flow restriction are becoming more salient. The lumina typically used range from 23-gauge to 27-gauge. There is conflicting evidence regarding the impact of gauge on the duration of surgery. Methods This retrospective single center, single surgeon study compared 23-gauge and 27-gauge vitrectomy for idiopathic epiretinal membranes. 104 eyes (104 patients) for 23-gauge vitrectomy and 109 eyes (109 patients) for 27-gauge vitrectomy were analyzed in terms of surgery time, pre- and post-operative best corrected visual acuity, change of central foveal thickness and complications within one year after the surgery. Results The surgery times between the 23-gauge and 27-gauge group did not differ significantly, being 17 and 18 minutes respectively (p > 0,05). In a subgroup analysis, this remained true for vitrectomies with concurrent cataract surgery, but in the small subset of patients without concurrent cataract surgery the data was inconclusive. Endophthalmitides occurred in 1 percent and 2,8 percent in the 23-gauge and 27-gauge group respectively (p > 0,05). The visual acuity improved for the 23-gauge group from 0,4 logMAR (Snellen equivalent 0,4) and for the 27-gauge group from 0,3 logMAR (Snellen equivalent 0,5) to postoperative values of 0,2 logMAR (Snellen equivalent 0,63). The central foveal thickness decreased significantly after the surgery compared to pre-operative values similarly in both groups. Conclusion 23- and 27-gauge pars plana vitrectomies showed similar surgical times and success profiles.