Incidence of endophthalmitis in a large series of 23-gauge and 20-gauge transconjunctival pars plana vitrectomy

  • Barbara Parolini
  • Federica Romanelli
  • Guido Prigione
  • Grazia Pertile
Retinal Disorders



To study the incidence of endophthalmitis after 23-gauge pars plana vitrectomy and to compare it with the endophthalmitis rate after 20-gauge pars plana vitrectomy performed in the same ophthalmology department.


The charts of 4,021 consecutive 20-gauge or 23-gauge pars plana vitrectomies performed at a single institution, between August 1 2003 and April 1 2008, were reviewed to search for the occurrence of postoperative endophthalmitis. This is a retrospective, interventional, comparative cohort study.


Endophthalmitis developed in one of 3,078 eyes after 20-gauge vitrectomy (0.03%) and in none of 943 eyes after 23-gauge vitrectomy.


We did not find an increased risk of endophthalmitis after 23-gauge sutureless vitrectomy.


Sutureless vitrectomy Sclerotomy sites Endophthalmitis 


  1. 1.
    Kattan HM, Flynn HW Jr, Pflugfelder SC, Robertson C, Forster RK (1991) Nosocomial endophthalmitis survey. Current incidence of infection after intraocular surgery. Ophthalmology 98:227–238PubMedGoogle Scholar
  2. 2.
    May DR, Peyman GA (1976) Endophthalmitis after vitrectomy. Am J Ophthalmol 81:520–521PubMedGoogle Scholar
  3. 3.
    Chen JC (1996) Sutureless pars plana vitrectomy through self-sealing sclerotomies. Arch Ophthalmol 114:1273–1275PubMedGoogle Scholar
  4. 4.
    Fujii GY, De Juan E Jr, Humayun MS et al (2002) A new 25-gauge instrument system for transconjunctival sutureless vitrectomy surgery. Ophthalmology 109:1807–1812. doi:10.1016/S0161-6420(02)01179-X, discussion 1813PubMedCrossRefGoogle Scholar
  5. 5.
    Chen E (2007) 25-Gauge transconjunctival sutureless vitrectomy. Curr Opin Ophthalmol 18:188–193. doi:10.1097/ICU.0b013e328133889a PubMedCrossRefGoogle Scholar
  6. 6.
    Lakhanpal RR, Humayun MS, de Juan E Jr et al (2005) Outcomes of 140 consecutive cases of 25-gauge transconjunctival surgery for posterior segment disease. Ophthalmology 112:817–824. doi:10.1016/j.ophtha.2004.11.053 PubMedCrossRefGoogle Scholar
  7. 7.
    Kellner L, Wimpissinger B, Stolba U, Brannath W, Binder S (2007) 25-gauge vs 20-gauge system for pars plana vitrectomy: a prospective randomised clinical trial. Br J Ophthalmol 91:945–948. doi:10.1136/bjo.2006.106799 PubMedCrossRefGoogle Scholar
  8. 8.
    Rizzo S, Genovesi-Ebert F, Murri S et al (2006) 25-gauge, sutureless vitrectomy and standard 20-gauge pars plana vitrectomy in idiopathic epiretinal membrane surgery: a comparative pilot study. Graefes Arch Clin Exp Ophthalmol 244:472–479. doi:10.1007/s00417-005-0173-6 PubMedCrossRefGoogle Scholar
  9. 9.
    Cho YJ, Lee JM, Kim SS (2004) Vitreoretinal surgery using transconjunctival sutureless vitrectomy. Yonsei Med J 45:615–620PubMedGoogle Scholar
  10. 10.
    Ibarra MS, Hermel M, Prenner JL, Hassan TS (2005) Longer-term outcomes of transconjunctival sutureless 25-gauge vitrectomy. Am J Ophthalmol 139:831–836. doi:10.1016/j.ajo.2004.12.002 PubMedCrossRefGoogle Scholar
  11. 11.
    Fujii GY, De Juan E Jr, Humayun MS et al (2002) Initial experience using the transconjunctival sutureless vitrectomy system for vitreoretinal surgery. Ophthalmology 109:1814–1820. doi:10.1016/S0161-6420(02)01119-3 PubMedCrossRefGoogle Scholar
  12. 12.
    Kunimoto DY, Kaiser RS (2007) Incidence of endophthalmitis after 20- and 25-gauge vitrectomy. Ophthalmology 114:2133–2137. doi:10.1016/j.ophtha.2007.08.009 PubMedCrossRefGoogle Scholar
  13. 13.
    Chen JK, Khurana RN, Nguyen QD, Do DV (2008) The incidence of endophthalmitis following transconjunctival sutureless 25- vs 20-gauge vitrectomy. Eye Jun 6 [Epub ahead of print]Google Scholar
  14. 14.
    Scott IU, Flynn HW Jr, Dev S et al (2008) Endophthalmitis after 25-gauge and 20-gauge pars plana vitrectomy: incidence and outcomes. Retina 28:138–142PubMedCrossRefGoogle Scholar
  15. 15.
    Eckardt C (2005) Transconjunctival sutureless 23-gauge vitrectomy. Retina 25:208–211. doi:10.1097/00006982-200502000-00015 PubMedCrossRefGoogle Scholar
  16. 16.
    Cohen SM, Flynn HW Jr, Murray TG, Smiddy WE (1995) Endophthalmitis after pars plana vitrectomy. The Postvitrectomy Endophthalmitis Study Group. Ophthalmology 102:705–712PubMedGoogle Scholar
  17. 17.
    Eifrig CW, Scott IU, Flynn HW Jr, Smiddy WE, Newton J (2004) Endophthalmitis after pars plana vitrectomy: Incidence, causative organisms, and visual acuity outcomes. Am J Ophthalmol 138:799–802. doi:10.1016/j.ajo.2004.06.035 PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Barbara Parolini
    • 1
  • Federica Romanelli
    • 1
  • Guido Prigione
    • 1
  • Grazia Pertile
    • 1
  1. 1.Ospedale Sacro CuoreNegrar-VeronaItaly

Personalised recommendations