Multicenter survey of sutureless 27-gauge vitrectomy for primary rhegmatogenous retinal detachment: a consecutive series of 410 cases

Abstract

Purpose

To evaluate the surgical outcomes of the 27-gauge (G) vitrectomy system for the treatment of primary rhegmatogenous retinal detachment (RRD).

Methods

This retrospective consecutive series multicenter study involved a total of 410 eyes of 406 patients who underwent 3-port transconjunctival 27G pars plana vitrectomy (PPV) for RRD between November 2014 and December 2016 and who were followed for a minimum of 3 months postoperative. The main outcome measure was primary reattachment, with the secondary outcome measures being final reattachment, improvement of visual acuity (VA), intraocular pressure (IOP), intraoperative and postoperative complications, and surgery time.

Results

Of the 410 treated eyes, primary reattachment was achieved in 392 (95.6%) and final reattachment was achieved in 410 (100%). In 226 eyes (55.1%) with macula-on RRD, the mean logarithm of the minimum angle of resolution (logMAR) VA improved from 0.16 ± 0.51 pre-surgery to 0.02 ± 0.14 post-surgery (P = 0.11). In 184 eyes (44.9%) with macula-off RRD, logMAR VA improved from 1.06 ± 0.77 pre-surgery to 0.26 ± 0.35 post-surgery (P < 0.001). Following surgery, the mean IOP was highest at 1 day (15.7 ± 7.0 mmHg) postoperative. In all eyes, surgery was concluded without the use of sutures or the need of conversion to a larger-gauge instrument. Although hypotony was observed in 14 (3.4%) of the 410 treated eyes at 1 day postoperative, it spontaneously resolved within 1 week without additional surgical intervention. No postoperative complications such as infectious endophthalmitis were observed throughout the follow-up period.

Conclusion

Our findings show that 27G PPV is both safe and effective for the treatment of primary RRD.

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Acknowledgments

The authors wish to thank John Bush for reviewing the manuscript.

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Correspondence to Kazuhito Yoneda.

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The authors declare that they have no conflict of interest.

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All procedures performed in this retrospective multicenter survey study involving human participants were in accordance with the ethical standards of the requirements for a parallel Institutional Review Board (IRB; Registration No. UMIN000031103) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Appendix

Appendix

The 27G Vitrectomy Study Group is comprised of the following participating investigators: Yoichiro Shinkai, Kazuhito Yoneda, Chie Sotozono (Kyoto Prefectural University of Medicine, Kyoto, Japan), Yusuke Oshima (Oshima Eye Clinic, Takatsuki, Japan), Jiro Kogo (Department of Ophthalmology, St. Marianna University School of Medicine, Kanagawa, Japan), Hisanori Imai (Kobe University Graduate School of Medicine, Kobe, Japan), Akira Watanabe (Department of Ophthalmology, Jikei University School of Medicine, Tokyo, Japan), Yoshitsugu Matsui (Mie University Graduate School of Medicine, Mie, Japan), Kotaro Suzuki (Department of Ophthalmology, Keiyu Hospital, Kanagawa, Japan), Shinsuke Ataka (Department of Ophthalmology, Osaka University Graduate School of Medicine, Osaka, Japan), Shunsuke Osawa (Department of Ophthalmology, the MIE Ganka, Yotsukaichi, Japan), Tsukasa Hanemoto (Department of Ophthalmology, Kozawa Eye Hospital and Diabetes Center, Mito Japan), Hideyasu Oh (Department of Ophthalmology, Hyogo Prefectural Amagasaki General Medical Center, Hyogo, Japan), Akira Kobori (Department of Ophthalmology, Fukui Red Cross Hospital, Fukui, Japan), and Tomohisa Nishimura (Mikawa Eye Clinic, Saga, Japan).

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Shinkai, Y., Oshima, Y., Yoneda, K. et al. Multicenter survey of sutureless 27-gauge vitrectomy for primary rhegmatogenous retinal detachment: a consecutive series of 410 cases. Graefes Arch Clin Exp Ophthalmol 257, 2591–2600 (2019). https://doi.org/10.1007/s00417-019-04448-2

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Keywords

  • 27-Gauge (G)
  • Pars plana vitrectomy (PPV)
  • Primary rhegmatogenous retinal detachment (RRD)
  • Sutureless