Naruse S, et al. - A comparative exploration was performed of the postoperative outcomes of 27-gauge (G) and 25-G vitrectomy performed for the treatment of idiopathic epiretinal membrane (ERM). It was noted that 27-G vitrectomy displayed the necessity of operation time of 4 min longer compared to 25-G vitrectomy for ERM surgery. However, the utility of the 27-G system led to an earlier recovery of visual acuity, CRT improvement and stabilized ocular pressure.

Methods

• The plot of this research was a single center, retrospective, interventional case series.
• The enrollment consisted of two hundred consecutive eyes that underwent primary vitrectomy for ERM (27-G vitrectomy in 100 eyes and 25-G vitrectomy in 100 eyes), examined for 6 months.
• During this study, scleral tunnels were made in all eyes, using angle incisions, and air or gas exchange was performed.

Results

• No substantial variations were noted in age, spherical diopter power, as well as preoperative Early Treatment Diabetic Retinopathy Study (ETDRS) score, central retinal thickness (CRT), and intraocular pressure between the 27-G and 25-G groups.
• There was no prominent difference in the proportions of simultaneous cataract surgery (27-G vs. 25-G: 82% vs. 90%), air-filled eyes (99% vs. 98%), and scleral wound suture at the end of surgery (0% vs. 0%) among both groups.
• Markedly (P = 0.0322) longer mean operation time was reported for vitrectomy by 4 min for 27-G (37 min) than the 25-G (33 min) vitrectomy.
• Gain in ETDRS score appeared to be considerably (P = 0.0421) better in 27-G group (4.7 ± 8.1 letters) compared to 25-G group (1.1 ± 13.6 letters) at 1 month post-vitrectomy.
• However, it did not vary prominently at 3 and 6 months (P = 0.0835 and 0.0569, respectively).
• Significantly (P = 0.0354) greater decrease was noted in CRT in the 27-G group (-24.2 ± 50.0 μm) compared to 25-G group (-8.0 ± 48.6 μm) at 1 month post-vitrectomy, but not at 3 and 6 months (P = 0.6059 and 0.1725, respectively).
• On postoperative day 1, there was hypotony (≤ 6 mmHg) in 2 eyes in 27-G group and 6 eyes in 25-G group.
• On the other hand, ocular hypertension (≥ 25 mmHg) was discovered in 4 eyes in 27-G group and 11 eyes in 25-G group, with no marked variations between two groups.
• Occurrence of postoperative complications requiring treatment were reported in one eye (vitreous hemorrhage) in 27-G group, and in two eyes (vitreous hemorrhage and retinal detachment in one eye each) in 25-G group.