scholarly journals 23-Gauge versus 25-Gauge vitrectomy for proliferative diabetic retinopathy: A comparison of surgical outcomes

2015 ◽  
Vol 93 ◽  
pp. n/a-n/a
Author(s):  
H. Magill ◽  
G. Guthrie ◽  
D. Steel
Keyword(s):  
Diabetic Retinopathy ◽  
Proliferative Diabetic Retinopathy ◽  
Surgical Outcomes ◽  
23 Gauge ◽  
25 Gauge Vitrectomy

scholarly journals 23-Gauge versus 25-Gauge Vitrectomy for Proliferative Diabetic Retinopathy: A Comparison of Surgical Outcomes

2014 ◽  
Vol 233 (2) ◽  
pp. 104-111 ◽  
Author(s):  
Grant Guthrie ◽  
Henry Magill ◽  
David H.W. Steel
Keyword(s):  
Diabetic Retinopathy ◽  
Proliferative Diabetic Retinopathy ◽  
Transconjunctival Sutureless Vitrectomy ◽  
Retinal Breaks ◽  
Significant Difference ◽  
23 Gauge ◽  
Using Data ◽  
Sutureless Vitrectomy ◽  
25 Gauge Vitrectomy ◽  
Vitrectomy System

Purpose: This study compared clinical outcomes and complications between 23-gauge (23g) and 25-gauge (25g) transconjunctival sutureless vitrectomy in patients with proliferative diabetic retinopathy. Study Design: It was a retrospective study using data prospectively defined and collected. 80 eyes underwent 23g transconjunctival sutureless vitrectomy, and 80 eyes underwent 25g surgery using the same vitrectomy system by one surgeon. Primary outcome measures were best-corrected visual acuity, intraocular pressure (IOP), and incidence of intraoperative and postoperative complications. Results: Vision was significantly improved after intervention in both groups (p ≥ 0.0001). There was no significant difference in visual outcomes between the groups (p = 0.43) or in the type and frequency of retinal breaks occurring during surgery (p = 0.63). The 23g group had significantly more patients with a day 1 IOP of <6 mm Hg (p = 0.034) and significantly more patients requiring a sclerostomy suture postoperatively (p = 0.014). Conclusion and Message: Both gauges are equally effective for the treatment of proliferative diabetic retinopathy.

scholarly journals Risk Factors of Neovascular Glaucoma After 25-gauge Vitrectomy for Proliferative Diabetic Retinopathy with Vitreous Hemorrhage: A Retrospective Multicenter Study

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Kei Takayama ◽  
Hideaki Someya ◽  
Hiroshi Yokoyama ◽  
Yoshihiro Takamura ◽  
Masakazu Morioka ◽  
...  
Keyword(s):  
Risk Factors ◽  
Diabetic Retinopathy ◽  
Proliferative Diabetic Retinopathy ◽  
Multicenter Study ◽  
Vitreous Hemorrhage ◽  
Neovascular Glaucoma ◽  
Panretinal Photocoagulation ◽  
Uncontrolled Diabetes ◽  
Surgical Options ◽  
25 Gauge Vitrectomy

Abstract Neovascular glaucoma (NVG) is a terminal severe complication in eyes with proliferative diabetic retinopathy (PDR), and PDR eyes with vitreous hemorrhage (VH) which undergo vitrectomy may have higher risk of postoperative NVG. The incidence and the prognostic factor of postoperative NVG after 25-gauge vitrectomy with advanced surgical options remain unclear. We retrospectively reviewed medical records of 268 eyes of 268 consecutive PDR patients with VH who underwent 25-gauge vitrectomy and 12 months follow-up at seven centers. Preoperative ocular factors (visual acuity, tractional retinal detachment, panretinal photocoagulation [PRP]), demographics and clinical factors (sex, age, diabetic duration, HbA1c, hypertension, anticoagulant medication, and kidney function), surgical procedures, and postoperative complications were compared between patients who developed postoperative NVG (9.3%) and those who did not. NVG eyes was significantly younger (P = 0.026), had shorter diabetic duration (P = 0.022), higher HbA1c (P = 0.028), absence of PRP (P = 0.039) and higher frequency of postoperative VH (P = 0.0075) than non-NVG eyes. Logistic regression analysis identified postoperative VH (P = 0.014), shorter diabetic duration (P = 0.029), and no PRP (P = 0.028) as prognostic factors for postoperative NVG. This multicenter study indicates that younger age, uncontrolled diabetes, no PRP, and postoperative VH are risk factors of post-vitrectomy NVG.

scholarly journals Efficacy and Safety of Intravitreal Conbercept, Ranibizumab, and Triamcinolone on 23-Gauge Vitrectomy for Patients with Proliferative Diabetic Retinopathy

2018 ◽  
Vol 2018 ◽  
pp. 1-11 ◽  
Author(s):  
Jinglin Cui ◽  
Hong Chen ◽  
Hang Lu ◽  
Fangtian Dong ◽  
Dongmei Wei ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Proliferative Diabetic Retinopathy ◽  
Silicone Oil ◽  
Operation Time ◽  
Intravitreal Ranibizumab ◽  
Intravitreal Triamcinolone ◽  
Retinal Breaks ◽  
Pars Plana ◽  
Silicone Oil Tamponade ◽  
23 Gauge

Introduction. To compare the effect and safety of intravitreal conbercept (IVC), intravitreal ranibizumab (IVR), or intravitreal triamcinolone acetonide (IVTA) injection on 23-gauge (23-G) pars plana vitrectomy (PPV) for proliferative diabetic retinopathy (PDR). Methods. Fifty patients (60 eyes) of varying degrees of PDR were randomly grouped into 3 groups (1 : 1 : 1) (n=20 in each group). The 23-G PPV was performed with intravitreal conbercept or ranibizumab injection 3–7 days before surgery or intravitreal TA injection during surgery. The experiment was randomized controlled, with a noninferiority limit of five letters. Main outcome measures included BCVA, operation time, incidence of iatrogenic retinal breaks, endodiathermy rate, and silicone oil tamponade. Results. At 6 months after surgery, there were no significant differences of BCVA improvements, operation time, incidence of iatrogenic retinal breaks, endodiathermy rate, silicone oil tamponade, vitreous clear-up time, and the incidence of intraoperative bleeding between the IVC and IVR groups (all P values ≥ 0.05), but they were significantly different from the IVTA group (all P values < 0.05). IOP increases did not show significant differences between the IVC and IVR groups, but both were significantly different with the IVTA group. More patients had higher postoperative IOP in the IVTA group. Conclusions. The intravitreal injection of conbercept, ranibizumab, or TA for PDR had a significant different effect on outcomes of 23-G PPV surgery. Conbercept and ranibizumab can reduce difficulty of the operation, improve the success rate of PPV surgery, and decrease the incidence of postoperative complications.

Outcomes of 25-gauge vitrectomy for proliferative diabetic retinopathy

2010 ◽  
Vol 249 (3) ◽  
pp. 369-376 ◽  
Author(s):  
Mahmoud Mohamed Farouk ◽  
Takeshi Naito ◽  
Khulood Mohammed Sayed ◽  
Toshihiko Nagasawa ◽  
Takashi Katome ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Proliferative Diabetic Retinopathy ◽  
25 Gauge Vitrectomy

Outcomes of Surgically Managed Proliferative Diabetic Retinopathy

2018 ◽  
Vol 2 (6) ◽  
pp. 338-342
Author(s):  
Amir Hadayer ◽  
Brett H. Mueller ◽  
Janelle Fassbender Adeniran ◽  
Charles C. Barr
Keyword(s):  
Diabetic Retinopathy ◽  
Proliferative Diabetic Retinopathy ◽  
Vision Loss ◽  
Average Duration ◽  
Vitreous Hemorrhage ◽  
Retrospective Chart Review ◽  
University Of Louisville ◽  
Small Gauge ◽  
23 Gauge

Purpose: The purpose of this article is to conduct a retrospective chart review of the results of vitrectomy for diabetic vitreous hemorrhage (VH) and diabetic traction retinal detachment (TRD) using small-gauge instruments. Methods: We retrospectively reviewed medical records of all diabetic vitrectomies performed at the University of Louisville from 2012 to 2016 that had at least 6 months of follow-up. Patients included in this study underwent pars plana vitrectomy (PPV) for proliferative diabetic retinopathy complications. We analyzed the preoperative and 6- and 12-month postoperative visual acuities (VAs) in patients who had vitrectomy for their diabetic retinopathy. We also determined the proportion of patients who had best-corrected visual acuity (BCVA) of 20/40 or better and 20/80 or worse. In the patients who had BCVA of 20/80 or worse, we identified the reasons for the decreased VA. We also report intraocular pressure, demographic characteristics, operative techniques, and complications. Results: We identified 93 eyes that underwent diabetic vitrectomy; 81 eyes of 63 patients had at least 6 months’ follow-up. Of those 81 eyes, 40 eyes had VH only; the average duration of vision loss before surgery was 4.7 months. Forty-one eyes had TRDs with average duration of vision loss before surgery of 7 months. The presenting BCVA was 1.14 logMAR (20/300) in the VH-only group and 1.49 logMAR (20/600) in the TRD group ( P < .09). Six months after surgery, the BCVA was 0.59 logMAR (20/80) in the VH-only group but still 1.37 logMAR (20/500) in the TRD group ( P < .001). By 12 months after surgery (63 eyes), the BCVA was 0.60 logMAR (20/80) vs 1.09 logMAR (20/250), respectively ( P < .02). Technical success was achieved in 79 of 81 eyes. At 12 months after surgery, 22 eyes (55%) in the VH-only group and 19 eyes (46%) in the TRD group gained 15 letters or more (doubling the VA) compared with their presenting VA. In the VH-only group 7 eyes (18%) were 23-gauge (G) PPV, 22 (58%) were 25G PPV, and 9 (24%) were 27G PPV, while in the TRD group 15 (38%) were 20G PPV, 11 (27%) were 23G PPV, and 14 (35%) were 25G PPV. There was no difference in outcome with different gauges. Conclusions: While vitrectomy for complications of diabetic retinopathy was technically successful with small-gauge surgery, visual results were disappointing. Further work is needed to clarify the best timing of surgery to improve visual outcomes.

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