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25-gauge, sutureless vitrectomy and standard 20-gauge pars plana vitrectomy in idiopathic epiretinal membrane
Stanislao Rizzo1, Federica Genovesi-Ebert, Simona Murri
1Santa Chiara Hospital, Eye Surgery Clinic, Via Roma 67, 56100, Pisa, Italy. chiroftalmica@ao-pisa.toscana.it
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.
Insights
Sutureless 25-gauge vitrectomy (TSV) offers a safer, faster, and more comfortable alternative for epiretinal membrane (ERM) surgery compared to traditional 20-gauge systems. This advanced technique leads to quicker visual recovery and potentially fewer complications like cataracts.
Area of Science:
- Ophthalmology
- Surgical Innovation
- Retinal Surgery
Background:
- Idiopathic epiretinal membranes (ERM) affect vision and require surgical intervention.
- Traditional 20-gauge vitrectomy is a standard treatment for ERM.
- Evaluating novel surgical approaches is crucial for improving patient outcomes.
Purpose of the Study:
- To compare the safety and functional outcomes of sutureless 25-gauge vitrectomy (TSV) with standard 20-gauge vitrectomy for ERM treatment.
- To assess differences in surgical time, complications, and patient recovery between the two techniques.
Main Methods:
- Prospective evaluation of 46 patients with idiopathic ERM.
- Group 1: 26 patients underwent transconjunctival sutureless 25-gauge vitrectomy (TSV).
- Group 2: 20 patients underwent standard 20-gauge vitrectomy. Both groups involved ERM removal and internal limiting membrane (ILM) peeling.
Main Results:
- No surgery-related complications in either group.
- TSV group had significantly shorter operating times (15.6 min vs 29.6 min) and less BSS consumption.
- TSV group showed reduced postoperative discomfort, inflammation, and faster visual acuity improvement.
- Cataract formation occurred in two eyes in the 20-gauge group.
Conclusions:
- Transconjunctival sutureless vitrectomy (TSV) is a safe and effective technique for ERM surgery.
- TSV reduces operating time, minimizes trauma, and lowers postoperative inflammation and discomfort.
- TSV may lead to a lower incidence of cataract formation and accelerates postoperative recovery.
