Comparison of the 20-gauge conventional vitrectomy technique with the 23-gauge releasable suture vitrectomy technique

Korean J Ophthalmol. 2013 Feb;27(1):12-8. doi: 10.3341/kjo.2013.27.1.12. Epub 2013 Jan 9.

Abstract

Purpose: To compare the efficacy of the transconjunctival releasable suture technique for pars plana vitrectomy using 23-gauge (23G) instruments versus the conventional 20-gauge (20G) technique.

Methods: A retrospective and interventional case series was consecutively performed for 199 eyes of the 192 patients that were a part of this study. Clinical data were reviewed retrospectively regarding the operation time, preoperative and postoperative intraocular pressure, visual acuity and astigmatism for 54 consecutive patients who received a 23G releasable suture vitrectomy and for 98 consecutive patients who received a 20G conventional vitrectomy during the period between April 2007 and September 2010.

Results: Mean operation time based on the operation record was 88.5 ± 20.1 minutes in the 23G releasable suture vitrectomy group and 102.1 ± 23.1 minutes in the 20G conventional vitrectomy group, respectively (p = 0.01). The last best-corrected visual acuity (BCVA) was significantly better than the preoperative BCVA in both patient groups (p = 0.01, p = 0.01). The 23G releasable suture group showed less surgically induced astigmatism than the 20G conventional vitrectomy group. Vitreous bleeding was observed to be in 6 eyes (5.9%) in the 23G group, and in 8 eyes (8.2%) in the 20G group. In addition, ocular hypertension was noted to be in 3 eyes (3.0%) in the 23G group, and 6 eyes (6.1%) in the 20G group. No serious complications such as postoperative hypotony or endophthalmitis were observed in either group.

Conclusions: The 23G releasable suture technique is as effective as the 20G conventional technique and offers several advantages.

Keywords: Vitrectomy; Vitreoretinal surgery.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Equipment Design
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • Suture Techniques / instrumentation*
  • Sutures*
  • Treatment Outcome
  • Visual Acuity
  • Vitrectomy / methods*
  • Vitreous Hemorrhage / physiopathology
  • Vitreous Hemorrhage / surgery*