20-gauge safer than 25-gauge surgery

Patients undergoing 25-gauge vitreoretinal surgery are more likely to experience postoperative serous choroidal effusion and hypotony than patients undergoing 20-gauge procedures, according to a report published in the October issue of Retina.

Saad Shaikh and co-workers from Rollins College and Central Florida Retina Consultants, Florida, US compared complication rates between two groups of 129 eyes treated with primary 25- or 20-gauge vitreoretinal surgery. Average follow-up was 9.1 months and 14.3 months in the 25- and 20-gauge groups, respectively.

The researchers found that both groups had similar rates of intraoperative complications, which were mainly rhematogenous in nature. A total of 46% of patients, in both groups, experienced cataract progression. Eyes treated with 25-gauge procedures, had a significantly higher incidence of postoperative complications; 7.9% developed hypotony and serous choroidal effusions compared with just 1.6% of the 20-gauge treated eyes. Two eyes in the 25-gauge group developed endophthalmitis.

It was the conclusion of the authors that 25-gauge surgery is more likely to result in postoperative complications than 20-gauge surgery.