Transconjunctival 20-gauge vitrectomy: a pilot study

To determine the efficacy of a novel technique for a 'transconjunctival 20-gauge vitrectomy' (T20V).

In total, 12 eyes of 12 consecutive patients were included in a prospective study. The mean age was 58 years (range: 38-74 years); 4 patients were male and 8 were female. The T20V was indicated when short-duration vitrectomy was envisioned: macular surgery for macular hole and epiretinal membrane therapy, moderate vitreous hemorrhage due to retina vein occlusions or diabetic retinopathy, or neurotomy for central retinal vein occlusion.

The average time for each procedure was 35 +/- 30 min (SD). The preoperative visual acuity ranged from 20/200 to hand motions, while postoperative vision was between 20/30 and counting fingers. The average intraocular pressure changed from 16.1 +/- 5.6 mm Hg preoperatively to 15.8 +/- 8.1 mm Hg in the first postoperative day, and 17.8 +/- 9.4 mm Hg 1 week after surgery - these differences were not statistically significant (p > 0.05). Subjective postoperative pain and foreign body sensation at postoperative day 1 and week 1 were mild to moderate. The chemosis observed 1 h after surgery was minimal, and disappeared quickly during the 1-week follow-up.

The T20V is suitable to perform short-duration vitrectomy surgery, and has a low rate of ocular complications, similar to 25- or 23-gauge sutureless vitrectomy systems.