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

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Abstract

Background

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.

Methods

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.

Results

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.

Conclusion

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.

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Authors and Affiliations

  1. Santa Chiara Hospital, Eye Surgery Clinic, Via Roma 67, 56100, Pisa, Italy

    Stanislao Rizzo, Federica Genovesi-Ebert, Simona Murri, Claudia Belting, Andrea Vento & Federica Cresti

  2. Department of Neuroscience, University of Pisa, 56100, Pisa, Italy

    Maria Laura Manca

Authors
  1. Stanislao Rizzo
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  2. Federica Genovesi-Ebert
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  3. Simona Murri
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  4. Claudia Belting
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  5. Andrea Vento
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  6. Federica Cresti
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  7. Maria Laura Manca
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Correspondence to Stanislao Rizzo.

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Rizzo, S., Genovesi-Ebert, F., Murri, S. et al. 25-gauge, sutureless vitrectomy and standard 20-gauge pars plana vitrectomy in idiopathic epiretinal membrane surgery: a comparative pilot study. Graefe's Arch Clin Exp Ophthalmo 244, 472–479 (2006). https://doi.org/10.1007/s00417-005-0173-6

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  • DOI: https://doi.org/10.1007/s00417-005-0173-6

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