Outcomes of transconjunctival sutureless 27-gauge vitrectomy for vitreoretinal diseases

AIM： To evaluate the safety and efficacy profile of 27-gauge （27G） pars plana vRrectomy （PPV） for the treatment of various vitreoretinal diseases. METHODS： The clinical outcomes of 61 eyes （58 patients） with various vitreoretinal diseases following 27G PPV were retrospectively reviewed. RESULTS： Surgical indications included rhegmatogenous retinal detachment （n=24）, full-thickness macular hole （n=12）, diabetic retinopathy （n=11）, vitreous hemorrhage （n=6）, Eales disease （n=4）, pathological myopia-related vitreous floater （n=2）, and macular epiretinal membrane （n=2）. The mean follow-up was 166.4±61.3d （range 98-339d）. The mean IogMAR best-corrected visual acuity （BCVA） improved from 1.7±1.1 [0.02 decimal visual acuity （VA） equivalent] preoperatively to 1.2±1.0 （0.06 decimal VA equivalent） at the last postoperative visit （P〈0.001）. The mean operative time was 49.gmin. With the exception of complicated cataract in one eye, no intraoperative complications were encountered. No case required conversion to conventional 20-, 23- or 25G instrumentation in all surgical maneuvers except for silicone oil infusion, which required a 25G oil injection syringe. Postoperative complications included transient ocular hypertension, vitreous hemorrhage, persistent intraocular pressure elevation, subconjunctival oil leakage, and recurrent retinal detachment. No cases of hypotony, endophthalmitis, and sclerotomy-related tears were observed. CONCLUSION： The current results suggest that 27G PPV system is a safe and effective treatment for various vitreoretinal diseases. When learning to perform 27G PPV,surgeons may encounter a learning curve and should gradually expand surgical indications from easy to pathologically complicated cases.

Outcomes of transconjuctival sutureless 27-gauge vitrectomy for stage 4 retinopathy of prematurity

AIM To report our initial experience with lens-sparing vitrectomy for stage 4 retinopathy of prematurity using the 27-gauge(G) system.METHODS This retrospective case series involved nine eyes of five babies with active stage 4 ROP, who underwent 27-G lens-sparing vitrectomy. Surgery was done using 27-G valved cannulas and sclerotomies were made 1.5 mm from the limbus. Bilateral sequential vitrectomy was done in eight eyes. RESULTS At one-year follow-up, anatomical outcome was favourable in all nine(100%) eyes. High-speed cutting and smaller sclerotomies were helpful in reducing the intra and post-operative complications. CONCLUSION27-G vitrectomy is well suited for stage 4 ROP surgeries.