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25 Gauge versus 20 Gauge System for Pars Plana Vitrectomy: A Prospective Randomized Clinical Trial
  1. Lukas Kellner (lukas.kellner{at}wienkav.at),
  2. Barbara Wimpissinger (barbara.wimpissinger{at}gmx.at),
  3. Ulrike Stolba (ulrike.stolba{at}wienkav.at),
  4. Werner Brannath (werner.brannath{at}meduniwien.ac.at),
  5. Susanne Binder (susanne.binder{at}wienkav.at)
  1. Rudolf Foundation Hospital, LB Institute for Retinology, Juchgasse 25, Austria
  2. Rudolf Foundation Hospital, LB Institute for Retinology, Juchgasse 25, Austria
  3. Rudolf Foundation Hospital, LB Institute for Retinology, Juchgasse 25, Austria
  4. Section of Medical Statistics, Medical University of Vienna, Austria, Austria
  5. Rudolf Foundation Hospital, LB Institute for Retinology, Juchgasse 25, Austria

    Abstract

    Aim: To compare 25 versus 20 gauge system for pars plana vitrectomy in a prospective, randomized, controlled clinical trial.

    Methods: Three port pars plana vitrectomy, done in 60 patients, two groups. Evaluations performed preoperatively, intraoperatively, first 3 postoperative days, 1 week, 1 and 3 months. Main outcome measure: time for surgery divided into duration of wound-opening, vitrectomy, retinal manipulation and wound closure.

    Results: Total duration of surgery showed no significant difference between the groups (p=0.67). The 25 gauge group showed significantly shorter duration of wound-opening (p<0.001) and wound-closure (p<0.001). In contrast, the vitrectomy duration was significantly longer in the 25 gauge group (p<0.001). Conjunctival injection and subjective postoperative pain showed significantly lower irritation in the 25 gauge group (p<0.001 respectively).

    Conclusion: The 25 gauge vitrectomy system offered a significantly improved patient comfort during the first postoperative week. The smaller surgical openings facilitated wound healing and minimized pain. Duration of surgery was comparable between the two systems, the shorter time needed for wound-opening and closure in the 25 gauge group being equalized by the longer vitrectomy duration. Intraoperative as well as retinal manipulation and illumination caused more surgical difficulties using the 25 gauge system.

    • 20 gauge
    • 25 gauge
    • vitrectomy

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