Role of bevacizumab in the prevention of early postoperative haemorrhage after 25-gauge microincision vitrectomy surgery

Objective: We combined heads-up 3-dimensional (3D) 27-gauge microincision vitrectomy surgery (27GMIVS) with a very low-intensity illumination system. Methods: This study was based on a retrospective, interventional case series of 6 eyes of 6 patients with macular disease. All patients underwent heads-up 3D 27GMIVS and the power of the intraocular illuminator was set to its minimum level, 1% (approximately 0.1 lm), throughout the surgery. Results: We found that the procedure was easy when the heads-up 3D system was used, but not through the eyepiece of a microscope. All surgeries were successfully finished without any complications. Postoperative visual acuity was restored or maintained in all eyes during the follow-up period. Conclusion: Heads-up, 3D system-assisted 27GMIVS with minimal illumination enabled excellent intraoperative visualization of retinal tissues, caused minimal phototoxicity to the macular retinal cells, and might therefore represent the next step in the development of an ideal, minimally invasive method of treating macular disease.

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Comparative Study of Corneal Wetting Agents During 25-Gauge Microincision Vitrectomy Surgery Under a Noncontact Wide-Angle Viewing System

Ophthalmic Surgery Lasers and Imaging Retina ◽

10.3928/23258160-20130715-07 ◽

2013 ◽

Vol 44 (4) ◽

pp. 360-365 ◽

Cited By ~ 2

Author(s):

Soo Hyun Kwon ◽

Jae Pil Shin ◽

In Taek Kim ◽

Dong Ho Park

Keyword(s):

Comparative Study ◽

Wide Angle ◽

Microincision Vitrectomy Surgery ◽

Wetting Agents ◽

Vitrectomy Surgery

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Combined Phacoemulsification and Pars Plana Vitrectomy for the Treatment of Cataract in Patients With Noninfectious Uveitis

Journal of VitreoRetinal Diseases ◽

10.1177/2474126420930489 ◽

2020 ◽

Vol 4 (5) ◽

pp. 393-400

Author(s):

Christopher D. Conrady ◽

Akbar Shakoor ◽

Rachel Patel ◽

Marissa Larochelle ◽

Majid Moshirfar ◽

...

Keyword(s):

Surgical Approach ◽

Inflammatory Disease ◽

Chart Review ◽

Retrospective Chart Review ◽

Visual Rehabilitation ◽

Disease Remission ◽

Pars Plana ◽

Vitrectomy Surgery

Purpose: This work evaluates the role of combined phacoemulsification and vitrectomy surgery in the management of cataract associated with noninfectious uveitis. Methods: A retrospective chart review was conducted of all patients aged 7 years or older who underwent a combined surgical approach from 2005 to 2018. Results: Eighty-five eyes of 67 patients were included in the study; 10.7% of eyes had a best-corrected visual acuity (BCVA) of 20/40 or better at time of surgery. At 1-year follow-up, 63.4% of eyes had a BCVA 20/40 or better and 7.6% had a BCVA of 20/200 or worse. There was an overall decrease in cystoid macular edema after surgery compared with preoperatively (47.6% vs 34.5% presurgery and postsurgery, respectively). Complete inflammatory disease remission off immunomodulatory therapy and systemic steroids was achieved in 21.1% of patients. Conclusions: A combined surgical approach is effective in visual rehabilitation in patients with uveitic cataracts and may promote inflammatory disease remission specifically in intermediate uveitis.

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Sutureless Microincision Vitrectomy Surgery: Unclear Benefit, Uncertain Safety

American Journal of Ophthalmology ◽

10.1016/j.ajo.2007.06.027 ◽

2007 ◽

Vol 144 (4) ◽

pp. 613-615 ◽

Cited By ~ 20

Author(s):

Hilel Lewis

Keyword(s):

Microincision Vitrectomy Surgery ◽

Vitrectomy Surgery

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Comparison of subconjunctival scarring after microincision vitrectomy surgery using 20-, 23-, 25- and 27-gauge systems in rabbits

Acta Ophthalmologica ◽

10.1111/aos.13459 ◽

2017 ◽

Vol 95 (7) ◽

pp. e602-e609 ◽

Cited By ~ 9

Author(s):

Makoto Gozawa ◽

Yoshihiro Takamura ◽

Seiji Miyake ◽

Kentaro Iwasaki ◽

Shogo Arimura ◽

...

Keyword(s):

Microincision Vitrectomy Surgery ◽

Vitrectomy Surgery ◽

Gauge Systems

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Comparison of 27-Gauge and 25-Gauge Microincision Vitrectomy Surgery for the Treatment of Vitreoretinal Disease: A Systematic Review and Meta-Analysis

Journal of Ophthalmology ◽

10.1155/2020/6149692 ◽

2020 ◽

Vol 2020 ◽

pp. 1-9

Author(s):

Jinlan Ma ◽

Qing Wang ◽

Haoyu Niu

Keyword(s):

Systematic Review ◽

Postoperative Complications ◽

Meta Analysis ◽

Operation Time ◽

Vitreoretinal Disease ◽

Subgroup Analyses ◽

Microincision Vitrectomy Surgery ◽

Anatomical Success ◽

Vitrectomy Surgery ◽

Anatomical Success Rate

Background. We performed a systematic review and meta-analysis to evaluate the safety and effectiveness of 27-gauge (27-G) microincision vitrectomy surgery (MIVS) compared with 25-guage (25-G) MIVS for the treatment of vitreoretinal disease. Methods. A systematic electronic search was conducted in March 2020 in PubMed, Embase, and the Cochrane library. Eligible criteria for including studies were controlled trials comparing 27-G vitrectomy with 25-G vitrectomy in patients with vitreoretinal disease. The main outcomes included operation time; best corrected visual acuity (BCVA) in logMAR; postoperative intraocular pressure (IOP); primary anatomical success rate for rhegmatogenous retinal detachment (RRD) cases and postoperative central macular thickness (CMT) for idiopathic epiretinal membrane (ERM) cases; intraoperative/postoperative complications. Odds ratio (OR) and mean difference (MD) were synthesized under fixed or random effects models. Results. Eleven studies enrolling 940 eyes were identified. Among those 11 studies, six studies were on the treatment of RRD and five studies were on the treatment of ERM, so subgroup analyses were conducted. The total pooled results indicated that 27-G surgery system had obvious advantages in improving BCVA at six months after the vitrectomy (P = 0.004) and reducing intraoperative/postoperative complications (P = 0.03). However, the mean operation time was significantly longer by three minutes for 27-G compared with 25-G vitrectomy (P = 0.002). In subgroup analyses, for the treatment of ERM cases, 27-G group was associated with less complications and longer operation time. However, for the treatment of RRD cases, 27-G groups and 25-G groups were comparable in operation time, postoperative BCVA, postoperative IOP, and primary anatomical success rate. Conclusions. This meta-analysis confirmed that 27-G MIVS was an effective and safe surgical system compared with 25-G MIVS for the treatment of RRD and ERM cases, even though 27-G system needs a longer surgical time.

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