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Iatrogenic retinal breaks and postoperative retinal detachments in microincision vitrectomy surgery compared with

G H Chen1, R Tzekov2, F Z Jiang1

  • 1Department of Ophthalmology, Quzhou People's Hospital, Quzhou, Zhejiang, People's Republic of China.

Eye (London, England)
|December 19, 2018
PubMed
Abstract

Insights

Microincision vitrectomy surgery (MIVS) shows a lower incidence of iatrogenic retinal breaks (IRBs) and postoperative retinal detachments (RDs) compared to traditional 20-gauge (20G) vitrectomy. This finding suggests MIVS may offer improved safety outcomes in retinal surgical procedures.

Area of Science:

  • Ophthalmology
  • Retinal Surgery
  • Surgical Techniques

Background:

  • Traditional 20-gauge (20G) vitrectomy has been the standard for vitreoretinal surgery.
  • Microincision vitrectomy surgery (MIVS) utilizes smaller gauge instruments, potentially altering surgical outcomes.
  • The comparative safety of MIVS versus 20G vitrectomy regarding iatrogenic complications requires detailed assessment.

Purpose of the Study:

  • To evaluate and compare the incidence of iatrogenic retinal breaks (IRBs) and postoperative retinal detachments (RDs).
  • To assess these complication rates between microincision vitrectomy surgery (MIVS) and 20-gauge (20G) vitrectomy.

Main Methods:

  • A comprehensive literature search was conducted to identify relevant studies.
  • A meta-analysis was performed on data from 32 studies, encompassing 14,373 eyes.
  • Comparative analysis focused on rates of IRBs and postoperative RDs between 20G vitrectomy and MIVS (including 23G and 25G subanalyses).

Main Results:

  • The incidence of IRBs was significantly higher in 20G vitrectomy compared to MIVS (OR=2.22, P<0.00001).
  • Postoperative RDs were also significantly more frequent following 20G vitrectomy than MIVS (OR=1.72, P=0.003).
  • Subanalyses for macular surgery and sclerotomy-related IRBs also favored MIVS, while surgically induced posterior vitreous detachment-related IRBs showed no significant difference.

Conclusions:

  • Microincision vitrectomy surgery (MIVS) is associated with a statistically significant lower risk of iatrogenic retinal breaks.
  • MIVS demonstrates a reduced incidence of postoperative retinal detachments when compared to 20-gauge vitrectomy.
  • These findings suggest MIVS offers a potentially safer alternative for vitreoretinal procedures, minimizing iatrogenic complications.

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