Twenty five-gauge sutureless vitrectomy versus 20-gauge vitrectomy in epiretinal membrane surgery

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  • Mohammed Sayed Khulood
    Department of Ophthalmology, Sohag Faculty of Medicine, Sohag University Department of Ophthalmology, Institute of Health Biosciences, the University of Tokushima Graduate School
  • Naito Takeshi
    Department of Ophthalmology, Institute of Health Biosciences, the University of Tokushima Graduate School
  • Mohamed Farouk Mahmoud
    Department of Ophthalmology, Sohag Faculty of Medicine, Sohag University Department of Ophthalmology, Institute of Health Biosciences, the University of Tokushima Graduate School
  • Nagasawa Toshihiko
    Department of Ophthalmology, Institute of Health Biosciences, the University of Tokushima Graduate School
  • Katome Takashi
    Department of Ophthalmology, Institute of Health Biosciences, the University of Tokushima Graduate School
  • Mousa Abd El-Latif Ismail
    Department of Ophthalmology, Sohag Faculty of Medicine, Sohag University
  • Mostafa Abdallah Ahmad
    Department of Ophthalmology, Sohag Faculty of Medicine, Sohag University
  • Ali Mohamed Usama
    Department of Ophthalmology, Sohag Faculty of Medicine, Sohag University
  • Mitamura Yoshinori
    Department of Ophthalmology, Institute of Health Biosciences, the University of Tokushima Graduate School

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Purpose: To compare visual outcomes, intraoperative and postoperative complications of 25-gauge transconjunctival sutureless vitrectomy (25-G TSV) versus conventional 20-gauge vitrectomy in epiretinal membrane (ERM) surgery. Methods: A retrospective comparative study was conducted on 200 eyes with idiopathic ERM who underwent either primary 20-gauge vitrectomy (n=95) or 25-G TSV (n=105) with 6 months follow up. The following parameters were collected and compared: age, gender, best corrected visual acuity (BCVA), intraocular pressure (IOP), postoperative anterior chamber inflammation, intraoperative and postoperative complications. Results: Twenty-five gauge group achieved a significantly better vision at the 1st postoperative month (p=0.008) and a significantly higher incidence of visual improvement 6 months postoperatively (p=0.04) than 20-gauge group. Intraocular pressure was significantly higher at the 1st, 3rd and 6th postoperative months compared with baseline in the 20-G group. However, in the 25-gauge group IOP remained near to the baseline at the same period. Twenty five-gauge group achieved a significantly lower anterior chamber inflammation and a lower incidence of postoperative cystoid macular edema (CME) (p=0.01), hyphema (p=0.000) and after cataract (p=0.000) than 20-gauge group. Conclusions: The 25-gauge sutureless vitrectomy achieves rapid and higher visual improvement, less postoperative inflammation and complications than the 20-gauge vitrectomy in ERM surgery. J. Med. Invest. 59: 69-78, February, 2012

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