Document Detail


Intraoperative retinal tear formation and postoperative rhegmatogenous retinal detachment in transconjunctival cannulated vitrectomy systems compared with the standard 20-gauge system.
MedLine Citation:
PMID:  22332210     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
OBJECTIVE: To compare 20-gauge standard pars plana vitrectomy (PPV) with transconjunctival cannulated PPV in the development of intraoperative retinal breaks and postoperative rhegmatogenous retinal detachments (RRDs) in a large series of patients undergoing PPV for macular pucker or macular hole.
METHODS: This study was conducted at an academic tertiary care vitreoretinal practice in Milwaukee, Wisconsin. Patients undergoing 3-port PPV with standard 20-gauge instrumentation were compared with patients undergoing 3-port PPV with transconjunctival cannulated systems, including 20 gauge, 23 gauge, and 25 gauge, from January 1, 2003, through December 31, 2009. The main outcome measures were rates of intraoperative retinal breaks and postoperative RRD.
RESULTS: Four hundred twenty-six unique eyes met inclusion criteria. Fifty-four of 426 eyes (12.7%) were diagnosed as having new retinal tears intraoperatively as follows: 47 of 204 patients (23.0%) undergoing the standard 20-gauge procedure developed intraoperative retinal tears compared with 7 of 211 patients (3.3%) undergoing the transconjunctival cannulated procedure (risk ratio [RR], 0.12; 95% CI, 0.05-0.26; P < .001). Patients experiencing intraoperative retinal tears were not at increased risk of developing postoperative RRD (RR, 1.4; 95% CI, 0.39-5.0; P = .61). Although a trend was present, transconjunctival cannulated vitrectomy was not significantly protective against the development of postoperative RRD (RR, 0.60; 95% CI, 0.17-1.3; P = .14).
CONCLUSION: Transconjunctival cannulated PPV, including 20-gauge, 23-gauge, and 25-gauge systems, is associated with significantly reduced rates of intraoperative retinal tear formation compared with standard 20-gauge PPV.
Authors:
Douglas J Covert; Christopher R Henry; Sandeep K Bhatia; Jason Croskrey; Cecilia R Sanchez; Dennis P Han
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Archives of ophthalmology     Volume:  130     ISSN:  1538-3601     ISO Abbreviation:  Arch. Ophthalmol.     Publication Date:  2012 Feb 
Date Detail:
Created Date:  2012-02-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7706534     Medline TA:  Arch Ophthalmol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  186-9     Citation Subset:  AIM; IM    
Affiliation:
Department of Ophthalmology, Medical College of Wisconsin, 925 N 87th St, Milwaukee, WI 53226. dhan@mcw.edu.
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