Comparison of 23G and 25G+ vitrectomy for treatment of proliferative diabetic retinopathy_Chinese Journal of Ocular Fundus Diseases

Authors：

ZengHongbo ,  ChenChangzheng

Eye Center, Renmin Hospital of Wuhan University, Wuhan 430060, China;

Corresponding author：

ChenChangzheng, Email: whuchenchzh@163.com

Keywords：

Diabetic retinopathy/surgery; Surgical procedures, minimally invasive; Vitrectomy

DOI：

10.3760/cma.j.issn.1005-1015.2014.02.007

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Objective To compare the outcomes of 23G and 25G plus (25G+) vitrectomy in treatment of proliferative diabetic retinopathy (PDR). Methods This is a prospective randomized study. Fifty-seven PDR patients (75 eyes) with symptoms requiring vitrectomy were randomly divided into 23G vitrectomy group (30 patients, 39 eyes) and 25G+ vitrectomy group (27 patients, 36 eyes). Visual acuity, intraocular pressures, ophthalmoscopy, B-scan ultrasound was examined before surgery. The follow-up period was 10.0 (23G group) and 8.5 months (25G+ group) respectively. Intraoperative complications, operation time, postoperative visual acuity, intraocular pressure, postoperative complications and postoperative ocular conditions were analyzed. Results The mean surgical times were (53.35±7.42) minutes and (49.16±5.17) minutes in 23G and 25G+ group respectively, and the difference was significant (t=4.37, P < 0.05). Iatrogenic injuries occurred in 11 eyes (28.21%) and 5 (13.89%) eyes in 23G and 25G+ group respectively, and the difference was significant (χ²=4.93, P < 0.05). The postoperative visual acuity of 23G and 25G+ group were improved compared to before surgery (χ²=16.81, 18.29; P < 0.05). At last follow-up, there was 25 eyes and 24 eyes with visual acuity≥0.05 in 23G and 25G+ groups respectively, and the difference was not significant (χ²=0.13, P > 0.05). Hypotony was detected in 7 and 3 eyes at the third postoperative day in 23G and 25G+ group respectively, and the difference was significant (χ²=5.67, P < 0.05). Conclusion 25G+ vitrectomy is a safe and effective treatment for PDR with shorter surgery time and fewer surgical complications.

Citation： ZengHongbo, ChenChangzheng. Comparison of 23G and 25G+ vitrectomy for treatment of proliferative diabetic retinopathy. Chinese Journal of Ocular Fundus Diseases, 2014, 30(2): 145-147. doi: 10.3760/cma.j.issn.1005-1015.2014.02.007 Copy

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11.	万婷, 罗燕, 邹玉平, 等. 25G微创玻璃体手术与20G玻璃体手术的临床对比研究[J].中华眼底病杂志, 2008, 24:60-61.
12.	Dogru M, Katakami C, Inoue M. Tear function and ocular surface changes in noninsulin-dependent diabetes mellitus[J]. Ophthalmology, 2001, 108:586-592.
13.	金姬, 陈丽红, 刘秀伦, 等.糖尿病患者泪膜功能的研究[J].中华眼科杂志, 2003, 39:10-13.

1. Helbig H. Surgery for diabetic retinopathy[J]. Ophthalmologica, 2007, 221:103-111.
2. 沈玺, 徐建敏, 李娜, 等. 23G和20G玻璃体手术治疗增生型糖尿病视网膜病变的对比观察[J].中华眼底病杂志, 2012, 28:232-236.
3. 武志峰, 周丽钧, 黄卫莉, 等.低分子量肝素预防人工晶体植入术后眼内纤维蛋白渗出的临床研究[J].中国实用眼科杂志, 2000, 18:592-594.
4. Sarrafizadeh R. Surgical management of diabetic traction retinal detachment[J]. Tech Ophthalmol, 2003, 1:218-222.
5. Eliott D, Hemedia T. Diabetic traction retinal detachment[J]. Int Ophthalmol Clin, 2009, 49:153-165.
6. Fujii GY, de Juan E, Humayun Ms, et al. Initial experience using the transconjunctival sutureless vitrectomy system for vitreoretinal surgery[J]. Ophthalmology, 2002, 109:1814-1820.
7. Eckardt C. Transconjunctival sutureless 23 gauge vitrectomy[J]. Retina, 2005, 25:208-211.
8. Inoue M, Noda K, Ishida S, et al. Intraoperative breakage of a 25-gauge vitreous cutter[J]. Am J Ophthalmol, 2004, 138:867-869.
9. Mentens R, Stalmans P. Comparison of 25, 23 and 20-gauge vitrectomy[J]. Curr Opin Ophthahmol, 2009, 20:195-199.
10. Woo SJ, Park KH, Hwang JM, et al. Risk factors associated with sclerotomy leakage and postoperative hypotony after 23-gauge transconjunctival sutureless vitrectomy[J]. Retina, 2009, 29:456-463.
11. 万婷, 罗燕, 邹玉平, 等. 25G微创玻璃体手术与20G玻璃体手术的临床对比研究[J].中华眼底病杂志, 2008, 24:60-61.
12. Dogru M, Katakami C, Inoue M. Tear function and ocular surface changes in noninsulin-dependent diabetes mellitus[J]. Ophthalmology, 2001, 108:586-592.
13. 金姬, 陈丽红, 刘秀伦, 等.糖尿病患者泪膜功能的研究[J].中华眼科杂志, 2003, 39:10-13.

Chinese Journal of Ocular Fundus Diseases

Comparison of 23G and 25G+ vitrectomy for treatment of proliferative diabetic retinopathy

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