Comparison of microinsicion vitrectomy and conventional 20-gauge vitrectomy for severe proliferative diabetic...

To compare the outcomes of 23-gauge (G) and 25G vitrectomy to 20G vitrectomy on eyes with severe proliferative diabetic retinopathy (PDR).

The medical records of 424 eyes of 347 patients with severe PDR were reviewed. There were 80 eyes that had 23G, 174 eyes that had 25G, and 170 eyes that had 20G vitrectomy. The incidences of postoperative vitreous hemorrhage, intraoperative retinal breaks, retinal detachment, and neovascular glaucoma were compared.

The incidence of intraoperative retinal breaks was significantly lower in the 23G group (21 %) than in the 20G group (35 %, P = 0.03) but not in the 25G group (26 %, P = 0.057). The incidence of postoperative retinal detachment was not significantly different among the three groups (P = 0.73). The incidence of postoperative vitreous hemorrhage that developed ≥1 month after vitrectomy was not different whether the eyes had panretinal photocoagulation or not (P = 0.15). The incidence of postoperative neovascular glaucoma was significantly lower in the 25G group (3 %) than in the 20G group (11 %, P = 0.01) but not significant compared with that in the 23G group (8 %, P = 0.72).

The lower incidence of intraoperative retinal breaks and postoperative neovascular glaucoma after microincision vitrectomy indicates that microincision vitrectomy should be considered for eyes with severe PDR.