Inviato: Sab 03 Nov, 2007 12:28 Oggetto: 25 vs. 20 gauge
alcune statistiche riguardanti le complicazioni post-operatorie della vitrectomia eseguita con tecnica 25 o 20 gauge. è importante premettere che nello studio non sono state specificate le patologie vitreo-retiniche per le quali si è proceduto all'operazione:
OSN SuperSite Top Story 11/1/2007
Study: Higher postop complication rate with 25- vs. 20-gauge vitreoretinal surgery
Patients who undergo 25-gauge vitreoretinal surgeries may have a significantly higher risk of postoperative serous choroidal effusion and hypotony compared with patients treated with 20-gauge procedures, according to a retrospective study.
The 25-gauge procedures may also increase the risk of endophthalmitis, the study authors noted.
Saad Shaikh, MD, and colleagues compared complication rates between two groups of 129 eyes treated with primary 25-gauge or 20-gauge vitreoretinal surgery. All procedures were performed by four surgeons at a single center between September 2002 and November 2005, according to the study.
Follow-up averaged 9.1 months in the 25-gauge group and 14.3 months in the 20-gauge group.
Investigators found that both groups had similar rates of intraoperative complications, which were mainly rhegmatogenous in nature. Specifically, intraoperative complications occurred in 4.7% of the 25-gauge group and 6.9% of the 20-gauge group.
Also, 46% of eyes in both groups experienced cataract progression.
However, eyes treated with 25-gauge procedures had a significantly higher incidence of postoperative complications. In particular, 7.9% of 25-gauge-treated eyes developed hypotony and serous choroidal effusions compared with 1.6% of 20-gauge-treated eyes (P = .02), according to the study.
Other postoperative complications included retinal tears and detachments in 5.4% of 25-gauge eyes and 4.7% of 20-gauge eyes, new vitreous hemorrhage in 3.9% of 25-gauge eyes and 0.8% of 20-gauge eyes and persistent vitreous hemorrhage in 5.4% of eyes in both groups.
Two eyes (1.6%) in the 25-gauge-treated group also developed endophthalmitis; no eyes in the 20-gauge-treated group experienced this complication, the authors noted.
"Operative indications and case selection may be important in minimizing the tendency toward certain postoperative events," they said.
The study is published in the October issue of Retina.
Ultrasound biomicroscopy findings of 25 G Transconjuctival Sutureless (TSV) and conventional (20G) pars plana sclerotomy in the same patient.
Keshavamurthy R, Venkatesh P, Garg S.
Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India. ravi-keshavamurthy@yahoo.co.in
BACKGROUND: Transconjunctival Sutureless Vitrectomy (TSV) is a recent advancement in vitreo-retinal surgical techniques involving the use of 25 G instruments through self-sealing sclerotomies. It has been hypothesized that there may be less chance of vitreous and retinal herniation in the scleral wound as compared to conventional sclerotomy incision. However there are no reports on differences in 20 gauge and 25 gauge sclerotomies using ultrasound biomicroscopy (UBM). We report herein the differences in sclerotomies undertaken with 20 gauge (G) and 25 gauge instruments in the same patient. CASE PRESENTATION: Ultrasound biomicroscopy of the sclerotomy sites was done in the same patient in whom both 20 G and 25 G sclerotomies had to be constructed during pars plana vitrectomy and the differences were studied. On day 2, we observed a wide gape at the site that had been enlarged using a 20G MVR blade. In contrast, the other two sites made transconjunctivally using the 25G trocar showed only a mild gape. Significant gape continued to persist at the subsequent evaluations on day 7 and day 14 only at the port, which had been enlarged. CONCLUSION: Healing of a 25 G sclerotomy is expectedly quite rapid, with inability to detect the site of sclerotomy in a short duration of 2 weeks post-operatively. This is as opposed to conventional sclerotomies, which might take up to 6-8 weeks post-operatively for complete opposition.
Non puoi inserire nuovi Topic in questo forum Non puoi rispondere ai Topic in questo forum Non puoi modificare i tuoi messaggi in questo forum Non puoi cancellare i tuoi messaggi in questo forum Non puoi votare nei sondaggi in questo forum