Iatrogenic peripheral retinal breaks are significantly lower in 23G vitrectomy for macular diseases

Iatrogenic peripheral retinal breaks occur less frequently in 23G vitrectomy than in 20G vitrectomy, according to a study published in Cornea.

Dr Tetsuro Nakano et al., Department of Ophthalmology, Kagoshima City Hospital, Kagoshima, Japan, conducted a retrospective, comparative, interventional case series. The study included 176 eyes undergoing 23G vitrectomy between January 2007 and November 2009 and 153 eyes undergoing 20G vitrectomy between January 2004 and June 2006. Eyes were split into a 23G vitrectomy group and a 20G vitrectomy group.

Patients had either idiopathic macular holes or idiopathic epiretinal membranes. A single surgeon performed every procedure at the same hospital. The main outcome measure was the number of intraoperative and postoperative iatrogenic peripheral retinal breaks discovered.

The findings presented that 1 eye in the 23G group and 11 eyes in the 20G group had iatrogenic peripheral retinal breaks. Within one month postoperatively, iatrogenic retinal breaks were found in 1 eye in the 23G group and 2 eyes in the 20G group. In the 23G group, 2 out of the 176 patients studied experienced iatrogenic retinal breaks overall. This is compared to 13 out of 153 patients in the 20G group.

Occurrence of iatrogenic retinal breaks was significantly higher in patients who underwent 20G vitrectomy than in patients who underwent 23G vitrectomy for macular diseases.