Document Detail

20-gauge and 23-gauge phacovitrectomy for idiopathic macular holes: comparison of complications and long-term outcomes.
MedLine Citation:
PMID:  23154500     Owner:  NLM     Status:  MEDLINE    
PURPOSE: To assess and compare the complications and long-term visual and anatomical outcomes of 20- and 23-gauge phacovitrectomy (PVT) for idiopathic macular hole repair.
METHODS: A retrospective, consecutive, interventional case series of 72 eyes with idiopathic macular holes were managed with 20-gauge PVT (n=36) or 23-gauge PVT (n=36). All patients underwent a posterior-chamber intra-ocular lens implantation and internal-limiting-membrane peel with the aid of either trypan blue or brilliant blue G(250) dyes.
RESULTS: The macular hole closure rate was 97% with 20-gauge PVT and 100% with 23-gauge PVT. Mean follow-up was 24.06 (±12.83) months with 20-gauge PVT and 17.47 (±5.79) with 23-gauge PVT. Mean visual acuity improvement in LogMar was 0.41 (±0.32) with 20-gauge PVT and 0.52 (±0.25) with 23-gauge PVT (P=0.135). The incidence of retinal breaks was higher with the 20-gauge PVT compared with the 23-gauge PVT, occurring in 13 (36.1%) and 4 (11.1%) cases, respectively (P=0.025). There were no cases of retinal detachment. Postoperative intraocular pressure (IOP), at day 1, was significantly higher with 20-gauge PVT at 24.77 (±12.68) mm Hg compared with 17.20 (±6.95) mm Hg in 23-gauge PVT (P=0.0028). Operating times were longer in 20-gauge PVT at 89.36 (±15.26) min compared with the 23-gauge PVT at 79.33 (±23.82) min (P=0.04).
CONCLUSION: The 20-gauge PVT compared with 23-gauge PVT for macular hole repair is a slightly longer procedure and was associated with an increased incidence of retinal breaks and short-term elevated IOP. Both techniques have comparable visual and anatomical outcomes, but the 23-gauge PVT has advantages with regard to safety profile and operating time.
R Krishnan; C Tossounis; Y Fung Yang
Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2012-11-16
Journal Detail:
Title:  Eye (London, England)     Volume:  27     ISSN:  1476-5454     ISO Abbreviation:  Eye (Lond)     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-01-10     Completed Date:  2013-06-04     Revised Date:  2014-01-09    
Medline Journal Info:
Nlm Unique ID:  8703986     Medline TA:  Eye (Lond)     Country:  England    
Other Details:
Languages:  eng     Pagination:  72-7     Citation Subset:  IM    
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MeSH Terms
Intraocular Pressure
Macula Lutea / surgery
Phacoemulsification / adverse effects,  methods*
Retinal Perforations / surgery*
Retrospective Studies
Visual Acuity
Vitrectomy / adverse effects,  methods*

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