23 G better than 20 G

The 23-gauge system for pars plana vitrectomy offers greater postoperative comfort for the patient than does the standard 20-gauge system, according to a study published online ahead of print by the British Journal of Ophthalmology.

Susanne Binder, of the Department of Ophthalmology at the Rudolph Foundation Clinic, Vienna, Austria, and colleagues conducted a prospective clinical trial comparing the outcomes of pars plana vitrectomy, in which the 60 subjects were randomized into two groups using either the 23- or the 20-gauge system.

The team noted that patients operated on with 23-gauge instruments experienced less postoperative pain and required fewer conjunctival injections than the group operated on with 20-gauge instruments. In addition, the 23-gauge group had shorter opening and closing times and longer vitrectomy times than the 20-gauge group, although postop visual acuity and intraocular pressure measurements did not differ between groups. Three adverse events were noted in the 23-gauge group, compared with none in the 20-gauge group.

Despite the increased incidence of adverse events, the team concluded that postoperative patient comfort is increased by the use of 23- rather than 20-gauge instruments.