25-gauge, sutureless vitrectomy and standard 20-gauge pars plana vitrectomy in idiopathic epiretinal membrane surgery: a comparative pilot study

• DOI: 10.1007/s00417-005-0173-6
• Publication Date: 2006-01-18T13:48:15Z
• Authors: Stanislao Rizzo; Federica Genovesi...; Simona Murri; Claudia Belting; Andrea Vento; Federica Cresti; Maria Laura Manca
• Keywords: Aged, 80 and over; Male; 25-gauge; Suture Techniques; Visual Acuity; Epiretinal Membrane; Pilot Projects; Middle Aged; sutureless pars plana vitrectomy; 03 medical and health sciences; 25-gauge; Idiopathic epiretinal membrane; Sutureless pars plana vitrectomy; Aged; Aged, 80 and over; Epiretinal Membrane; Female; Humans; Male; Middle Aged; Pilot Projects; Postoperative Complications; Prospective Studies; Visual Acuity; Vitrectomy; Suture Techniques; Ophthalmology; Postoperative Complications; 0302 clinical medicine; Vitrectomy; Humans; Female; Prospective Studies; idiopathic epiretinal membrane; Aged

The aim of the study was to evaluate the safety and functional outcome of a small incision, sutureless vitrectomy in the treatment of idiopathic epiretinal membranes (ERM) compared with a standard 20-gauge vitrectomy system.Forty-six consecutive patients with idiopathic ERM were recruited for this study and prospectively evaluated. In group 1 (n=26) we used a transconjunctival sutureless 25-gauge vitrectomy system (TSV), patients in group 2 (n=20) were operated on using a standard 20-gauge vitrectomy system. The ERM was removed and the internal limiting membrane (ILM) was peeled in all eyes. Surgery-related complications, operating time, intraoperative balanced salt solution (BSS) consumption, postoperative discomfort, postoperative intraocular inflammation, lens opacification, and long-term visual outcome are reported and compared.No surgery-related complications were observed in either group. Operating time was shorter in group 1 compared with group 2 (mean 15.6 and 29.6 min respectively). Intraoperative amount of BSS consumption was less in group 1 (mean 28 ml in group 1 and 42 ml in group 2). Postoperative discomfort and intraocular inflammation were significantly reduced in the 25-gauge group. In the 20-gauge group cataract formation requiring surgery was observed in two eyes. Visual acuity improved significantly in both groups. The 25-gauge group improved on average by more lines of vision and the improvement in vision was more rapid.The TSV system is a safe and efficient surgical technique for ERM surgery. Operating time is significantly reduced, minimizing surgery-induced trauma, and reducing postoperative intraocular inflammation and the patients' discomfort. The incidence of cataract formation may be less using TSV. Postoperative recovery is accelerated.