TY - JOUR
T1 - Intraoperative retinal tear formation and postoperative rhegmatogenous retinal detachment in transconjunctival cannulated vitrectomy systems compared with the standard 20-gauge system
AU - Covert, Douglas J.
AU - Henry, Christopher R.
AU - Bhatia, Sandeep K.
AU - Croskrey, Jason
AU - Sanchez, Cecilia R.
AU - Han, Dennis P.
PY - 2012/2
Y1 - 2012/2
N2 - Objective: To compare 20-gauge standard pars plana vitrectomy (PPV) with transconjunctival cannulated PPV in the development of intraoperative retinal breaks and postoperative rhegmatogenous retinal detachments (RRDs) in a large series of patients undergoing PPV for macular pucker or macular hole. Methods: This study was conducted at an academic tertiary care vitreoretinal practice in Milwaukee, Wisconsin. Patients undergoing 3-port PPV with standard 20-gauge instrumentation were compared with patients undergoing 3-port PPV with transconjunctival cannulated systems, including 20 gauge, 23 gauge, and 25 gauge, from January 1, 2003, through December 31, 2009. The main outcome measures were rates of intraoperative retinal breaks and postoperative RRD. Results: Four hundred twenty-six unique eyes met inclusion criteria. Fifty-four of 426 eyes (12.7%) were diagnosed as having new retinal tears intraoperatively as follows: 47 of 204 patients (23.0%) undergoing the standard 20-gauge procedure developed intraoperative retinal tears compared with 7 of 211 patients (3.3%) undergoing the transconjunctival cannulated procedure (risk ratio [RR], 0.12; 95% CI, 0.05-0.26; P<.001). Patients experiencing intraoperative retinal tears were not at increased risk of developing postoperative RRD (RR, 1.4; 95% CI, 0.39-5.0; P=.61). Although a trend was present, transconjunctival cannulated vitrectomy was not significantly protective against the development of postoperative RRD (RR, 0.60; 95% CI, 0.17-1.3; P=.14). Conclusion: Transconjunctival cannulated PPV, including 20-gauge, 23-gauge, and 25-gauge systems, is associated with significantly reduced rates of intraoperative retinal tear formation compared with standard 20-gauge PPV.
AB - Objective: To compare 20-gauge standard pars plana vitrectomy (PPV) with transconjunctival cannulated PPV in the development of intraoperative retinal breaks and postoperative rhegmatogenous retinal detachments (RRDs) in a large series of patients undergoing PPV for macular pucker or macular hole. Methods: This study was conducted at an academic tertiary care vitreoretinal practice in Milwaukee, Wisconsin. Patients undergoing 3-port PPV with standard 20-gauge instrumentation were compared with patients undergoing 3-port PPV with transconjunctival cannulated systems, including 20 gauge, 23 gauge, and 25 gauge, from January 1, 2003, through December 31, 2009. The main outcome measures were rates of intraoperative retinal breaks and postoperative RRD. Results: Four hundred twenty-six unique eyes met inclusion criteria. Fifty-four of 426 eyes (12.7%) were diagnosed as having new retinal tears intraoperatively as follows: 47 of 204 patients (23.0%) undergoing the standard 20-gauge procedure developed intraoperative retinal tears compared with 7 of 211 patients (3.3%) undergoing the transconjunctival cannulated procedure (risk ratio [RR], 0.12; 95% CI, 0.05-0.26; P<.001). Patients experiencing intraoperative retinal tears were not at increased risk of developing postoperative RRD (RR, 1.4; 95% CI, 0.39-5.0; P=.61). Although a trend was present, transconjunctival cannulated vitrectomy was not significantly protective against the development of postoperative RRD (RR, 0.60; 95% CI, 0.17-1.3; P=.14). Conclusion: Transconjunctival cannulated PPV, including 20-gauge, 23-gauge, and 25-gauge systems, is associated with significantly reduced rates of intraoperative retinal tear formation compared with standard 20-gauge PPV.
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U2 - 10.1001/archopthalmol.2011.1378
DO - 10.1001/archopthalmol.2011.1378
M3 - Article
C2 - 22332210
AN - SCOPUS:84856829714
SN - 0003-9950
VL - 130
SP - 186
EP - 189
JO - Archives of Ophthalmology
JF - Archives of Ophthalmology
IS - 2
ER -