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Small-Gauge Vitrectomy for Macular Surgery Using a Systematic Approach to Wound Closure: 27-Gauge vs 25-Gauge
Cory A Christensen1, Ian A Thompson2, Jared S Nielsen3
1Department of Ophthalmology, SUNY Upstate Medical University, Syracuse, NY, USA.
Journal of Vitreoretinal Diseases
|January 15, 2024
Summary
27-gauge vitrectomy is a safe and effective alternative for macular surgery, comparable to 25-gauge vitrectomy. This smaller gauge requires less manipulation for wound closure without increasing surgical time or complications.
Area of Science:
- Ophthalmology
- Surgical Innovation
Background:
- Macular surgery aims to improve vision by addressing conditions like epiretinal membrane and macular holes.
- Vitrectomy, a surgical removal of the vitreous humor, is a key procedure in macular surgery.
- Small-gauge vitrectomy (25-gauge and 27-gauge) offers potential benefits in minimally invasive eye surgery.
Purpose of the Study:
- To compare the efficacy of 25-gauge and 27-gauge vitrectomy for macular surgery.
- To evaluate surgical duration, wound closure, and complication rates between the two instrumentation sizes.
- To assess the effectiveness of a standardized wound closure protocol in small-gauge vitrectomy.
Main Methods:
- Retrospective chart review of 250 consecutive small-gauge vitrectomy surgeries (125 of 25-gauge and 125 of 27-gauge).
- Analysis included surgeries for epiretinal membrane, macular hole, or vitreomacular adhesion.
- Standardized wound closure protocol was applied and assessed during and immediately after surgery.
Main Results:
- No statistically significant differences in baseline characteristics between the 25-gauge and 27-gauge groups.
- Surgical duration was similar for both 25-gauge and 27-gauge vitrectomy (P=.07).
- Spontaneous wound closure was more frequent in the 27-gauge group (P=.22), with uncommon intraoperative and postoperative complications in both groups.
Conclusions:
- 27-gauge vitrectomy is a safe and effective alternative to 25-gauge vitrectomy for macular surgery.
- The 27-gauge system required less manipulation for wound closure with a standardized protocol.
- Smaller 27-gauge vitrectomy did not increase surgical time or complications compared to 25-gauge vitrectomy.
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