Comparison of 27-gauge vs 23-gauge vitrectomy in epiretinal membrane surgery

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.

Datum der Bewilligung	2022
Originalsprache	Englisch
Gradverleihende Hochschule	Medizinische Universität Graz
Betreuer/-in	Gerald Seidel (Betreuer*in)