RESUMO
PURPOSE OF REVIEW: To compare outcomes of 27-gauge and 23-gauge pars plana vitrectomy (PPV) for treatment of vitreoretinal diseases. RECENT FINDINGS: Sixty-eight patients undergoing microincisional PPV for treatment of vitreoretinal diseases were randomized 1â:â1 to 27-gauge or 23-gauge surgery with a 7500 cuts-per-minute vitrectomy probe. The most common reasons for vitrectomy were epiretinal membrane (49%) and vitreous hemorrhage (24%). Meanâ±âstandard deviation (SD) changes from immediate preoperative to immediate postoperative intraocular pressure were -0.40â±â6.60âmmHg in the 27-gauge and -3.05â±â7.64âmmHg in the 23-gauge group (adjusted mean difference 2.42âmmHg, 95% lower confidence limit 0.64, Pâ=â0.013), but these changes were not associated with primary reason for vitrectomy (Pâ=â0.065). Meanâ±âSD conjunctival edema grades in the 27-gauge and 23-gauge groups 1 week after surgery were 0.02â±â0.124 and 0.10â±â0.246, respectively (least squares mean difference -0.09, 95% upper confidence limit -0.03, Pâ=â0.004), and were 0.01â±â0.122 and 0.12â±â0.338, respectively, at the probe incision site. Conjunctival edema grades were similar in both groups at 1 and 3 months. Meanâ±âSD pain ratings on postoperative day 1 - an indicator of patient comfort - were similar in the two groups. SUMMARY: Smaller diameter vitrectomy instruments are associated with smaller reductions in immediate postoperative intraocular pressure.