Background/aims: To assess the outcomes of 23-gauge sutureless transconjunctival vitrectomies (TSV), as compared to 25-gauge TSV in macular hole surgeries.
Methods: A retrospective, consecutive, interventional case series of 47 eyes with idiopathic macular holes treated by 23- or 25-gauge TSV were analyzed.
Results: The operative time was 37.2 ± 8.9 min with 23-gauge TSV and 34.2 ± 8.7 min with 25-gauge TSV (P = 0.388). The anatomical success rate was 96% with 23-gauge TSV and 92% with 25-gauge TSV (P > 0.999). The logarithm of the minimal angle of resolution of best-corrected visual acuity (BCVA) at the sixth postoperative month was 0.19 ± 0.16 with 23-gauge TSV and 0.19 ± 0.25 with 25-gauge TSV (P = 0.521). Postoperative improvement in BCVA was comparable between the two TSVs. IOP on postoperative day 1 was lower with 25-gauge TSV (12.3 ± 4.9 mmHg) than with 23-gauge TSV (17.4 ± 5.8 mmHg) (P = 0.036). Complications included retinal break, intraoperative bleeding and slippage of the infusion cannula with 23-gauge TSV, while retinal detachment and postoperative hypotony occurred in the 25-gauge TSV group (P = 0.570).
Conclusion: 23-gauge TSV appears to be as safe and effective as 25-gauge TSV in macular hole surgery.