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Clinical outcomes of 23-gauge vitrectomy may be better than 20-gauge vitrectomy for retinal detachment repair.

Xia F, Jiang YQ - Mol. Vis. (2015)

Bottom Line: Baseline characteristics of RD patients between the 23-G group and the 20-G group were not significantly different (all p>0.05).However, no statistical significances in the postoperative retinal reattachment rate or visual acuity improvement in the logarithm of the minimum angle of resolution (logMAR) were detected between the 23-G group and the 20-G group (both p>0.05).The meta-analysis further confirmed a shorter postoperative wound closure time, as well as a lower postoperative IOP and incidence of MH in the 23-G group than in the 20-G group (all p<0.05), while neither the postoperative retinal reattachment rate nor the visual acuity improvement in the logMAR showed statistical significance (all p>0.05).

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, the Affiliated Hospital of Weifang Medical University, Weifang, P.R. China.

ABSTRACT

Objective: This study compared the clinical outcomes between 23-gauge (23-G) vitrectomy and 20-gauge (20-G) vitrectomy for the repair of retinal detachment (RD).

Methods: A retrospective comparative analysis of 135 RD patients was conducted between January, 2013 and September, 2014 in the Ophthalmology Department of the Affiliated Hospital of Weifang Medical College. The clinical outcomes of RD patients who underwent 23-G vitrectomy (n = 65) and 20-G vitrectomy (n = 70) were compared. A logistic regression analysis was used for prognostic factors in RD patients. A meta-analysis was performed using the comprehensive Meta-Analysis version 2.0 software.

Results: Baseline characteristics of RD patients between the 23-G group and the 20-G group were not significantly different (all p>0.05). The postoperative wound closure time was obviously shorter, and postoperative intraocular pressure (IOP; mmHg) and the incidence of macular holes (MH) were evidently lower in the 23-G group than in the 20-G group (all p<0.05). However, no statistical significances in the postoperative retinal reattachment rate or visual acuity improvement in the logarithm of the minimum angle of resolution (logMAR) were detected between the 23-G group and the 20-G group (both p>0.05). The meta-analysis further confirmed a shorter postoperative wound closure time, as well as a lower postoperative IOP and incidence of MH in the 23-G group than in the 20-G group (all p<0.05), while neither the postoperative retinal reattachment rate nor the visual acuity improvement in the logMAR showed statistical significance (all p>0.05).

Conclusions: Our retrospective comparative study of RD surgery using 20-G or 23-G techniques revealed a shorter postoperative wound closure time, as well as a lower postoperative IOP and incidence of MH in the 23-G group than in the 20-G group, confirming the superiority of 23-G vitrectomy over 20-G vitrectomy. This study provided a better option of 23-G vitrectomy for clinically managing RD.

No MeSH data available.


Related in: MedlinePlus

Comparison of wound closure time and IOP after 23-G vitrectomy and 20-G vitrectomy for RD. A: Comparison of wound closure time after 23-G vitrectomy and 20-G vitrectomy for RD in enrolled studies showed that four included studies revealing the postoperative wound closure time in the 23-G group was shorter than that in the 20-G group. B: Comparison of IOP after 23-G vitrectomy and 20-G vitrectomy for RD in enrolled studies showed that three included studies demonstrating that postoperative IOP in the 23-G group was lower than that in the 20-G group. C: Comparison of the incidence of MH after 23-G vitrectomy and 20-G vitrectomy for RD in enrolled studies showed that seven included studies presenting that the postoperative incidence of MH in the 23-G group was obviously lower than that in the 20-G group; 23-G vitrectomy, 23-gauge vitrectomy; 20-G vitrectomy, 20-gauge vitrectomy; RD, retinal detachment; IOP, intraocular pressure; MH, macular hole.
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f1: Comparison of wound closure time and IOP after 23-G vitrectomy and 20-G vitrectomy for RD. A: Comparison of wound closure time after 23-G vitrectomy and 20-G vitrectomy for RD in enrolled studies showed that four included studies revealing the postoperative wound closure time in the 23-G group was shorter than that in the 20-G group. B: Comparison of IOP after 23-G vitrectomy and 20-G vitrectomy for RD in enrolled studies showed that three included studies demonstrating that postoperative IOP in the 23-G group was lower than that in the 20-G group. C: Comparison of the incidence of MH after 23-G vitrectomy and 20-G vitrectomy for RD in enrolled studies showed that seven included studies presenting that the postoperative incidence of MH in the 23-G group was obviously lower than that in the 20-G group; 23-G vitrectomy, 23-gauge vitrectomy; 20-G vitrectomy, 20-gauge vitrectomy; RD, retinal detachment; IOP, intraocular pressure; MH, macular hole.

Mentions: In total, 13 clinical studies met our inclusion criteria for this meta-analysis [13,19,27-37]. A total of 3,235 RD patients were involved in this meta-analysis, including 1,738 patients undergoing 23-G vitrectomy and 1,497 patients undergoing 20-G vitrectomy. Four included studies, which reported the difference in postoperative wound closure time between the 23-G group and the 20-G group, revealed the postoperative wound closure time in the 23-G group was shorter than that in the 20-G group (SMD = -1.608, 95% CI = -3.206–-0.010, p = 0.049; as seen in Figure 1A). Three included studies, which reported the difference in postoperative IOP between the 23-G group and the 20-G group, demonstrated that postoperative IOP in the 23-G group was lower than that in the 20-G group (SMD = -0.748, 95% CI = -1.478–-0.018, p = 0.045; Figure 1B). Seven included studies that compared the postoperative incidence of MH of 23-G vitrectomy and 20-G vitrectomy showed that the postoperative incidence of MH in the 23-G group was obviously lower than that in the 20-G group (OR = 0.386, 95% CI = 0.245–0.606, p<0.001; Figure 1C). Five included studies compared the retinal reattachment rate after 23-G and 20-G vitrectomy and implied no observably statistical significance of postoperative incidence of retinal reattachment between the 23-G group and the 20-G group (OR = 0.938, 95% CI = 0.366–2.404, p = 0.894; Figure 2A). Additionally, six included studies assessed the visual acuity improvement in the logMAR after 23-G and 20-G vitrectomy, and no statistical significant in the visual acuity improvement in the logMAR was detected between the 23-G group and the 20-G group (SMD = -0.066, 95% CI = -0.396–0.264, p = 0.697; Figure 2B).


Clinical outcomes of 23-gauge vitrectomy may be better than 20-gauge vitrectomy for retinal detachment repair.

Xia F, Jiang YQ - Mol. Vis. (2015)

Comparison of wound closure time and IOP after 23-G vitrectomy and 20-G vitrectomy for RD. A: Comparison of wound closure time after 23-G vitrectomy and 20-G vitrectomy for RD in enrolled studies showed that four included studies revealing the postoperative wound closure time in the 23-G group was shorter than that in the 20-G group. B: Comparison of IOP after 23-G vitrectomy and 20-G vitrectomy for RD in enrolled studies showed that three included studies demonstrating that postoperative IOP in the 23-G group was lower than that in the 20-G group. C: Comparison of the incidence of MH after 23-G vitrectomy and 20-G vitrectomy for RD in enrolled studies showed that seven included studies presenting that the postoperative incidence of MH in the 23-G group was obviously lower than that in the 20-G group; 23-G vitrectomy, 23-gauge vitrectomy; 20-G vitrectomy, 20-gauge vitrectomy; RD, retinal detachment; IOP, intraocular pressure; MH, macular hole.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4556160&req=5

f1: Comparison of wound closure time and IOP after 23-G vitrectomy and 20-G vitrectomy for RD. A: Comparison of wound closure time after 23-G vitrectomy and 20-G vitrectomy for RD in enrolled studies showed that four included studies revealing the postoperative wound closure time in the 23-G group was shorter than that in the 20-G group. B: Comparison of IOP after 23-G vitrectomy and 20-G vitrectomy for RD in enrolled studies showed that three included studies demonstrating that postoperative IOP in the 23-G group was lower than that in the 20-G group. C: Comparison of the incidence of MH after 23-G vitrectomy and 20-G vitrectomy for RD in enrolled studies showed that seven included studies presenting that the postoperative incidence of MH in the 23-G group was obviously lower than that in the 20-G group; 23-G vitrectomy, 23-gauge vitrectomy; 20-G vitrectomy, 20-gauge vitrectomy; RD, retinal detachment; IOP, intraocular pressure; MH, macular hole.
Mentions: In total, 13 clinical studies met our inclusion criteria for this meta-analysis [13,19,27-37]. A total of 3,235 RD patients were involved in this meta-analysis, including 1,738 patients undergoing 23-G vitrectomy and 1,497 patients undergoing 20-G vitrectomy. Four included studies, which reported the difference in postoperative wound closure time between the 23-G group and the 20-G group, revealed the postoperative wound closure time in the 23-G group was shorter than that in the 20-G group (SMD = -1.608, 95% CI = -3.206–-0.010, p = 0.049; as seen in Figure 1A). Three included studies, which reported the difference in postoperative IOP between the 23-G group and the 20-G group, demonstrated that postoperative IOP in the 23-G group was lower than that in the 20-G group (SMD = -0.748, 95% CI = -1.478–-0.018, p = 0.045; Figure 1B). Seven included studies that compared the postoperative incidence of MH of 23-G vitrectomy and 20-G vitrectomy showed that the postoperative incidence of MH in the 23-G group was obviously lower than that in the 20-G group (OR = 0.386, 95% CI = 0.245–0.606, p<0.001; Figure 1C). Five included studies compared the retinal reattachment rate after 23-G and 20-G vitrectomy and implied no observably statistical significance of postoperative incidence of retinal reattachment between the 23-G group and the 20-G group (OR = 0.938, 95% CI = 0.366–2.404, p = 0.894; Figure 2A). Additionally, six included studies assessed the visual acuity improvement in the logMAR after 23-G and 20-G vitrectomy, and no statistical significant in the visual acuity improvement in the logMAR was detected between the 23-G group and the 20-G group (SMD = -0.066, 95% CI = -0.396–0.264, p = 0.697; Figure 2B).

Bottom Line: Baseline characteristics of RD patients between the 23-G group and the 20-G group were not significantly different (all p>0.05).However, no statistical significances in the postoperative retinal reattachment rate or visual acuity improvement in the logarithm of the minimum angle of resolution (logMAR) were detected between the 23-G group and the 20-G group (both p>0.05).The meta-analysis further confirmed a shorter postoperative wound closure time, as well as a lower postoperative IOP and incidence of MH in the 23-G group than in the 20-G group (all p<0.05), while neither the postoperative retinal reattachment rate nor the visual acuity improvement in the logMAR showed statistical significance (all p>0.05).

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, the Affiliated Hospital of Weifang Medical University, Weifang, P.R. China.

ABSTRACT

Objective: This study compared the clinical outcomes between 23-gauge (23-G) vitrectomy and 20-gauge (20-G) vitrectomy for the repair of retinal detachment (RD).

Methods: A retrospective comparative analysis of 135 RD patients was conducted between January, 2013 and September, 2014 in the Ophthalmology Department of the Affiliated Hospital of Weifang Medical College. The clinical outcomes of RD patients who underwent 23-G vitrectomy (n = 65) and 20-G vitrectomy (n = 70) were compared. A logistic regression analysis was used for prognostic factors in RD patients. A meta-analysis was performed using the comprehensive Meta-Analysis version 2.0 software.

Results: Baseline characteristics of RD patients between the 23-G group and the 20-G group were not significantly different (all p>0.05). The postoperative wound closure time was obviously shorter, and postoperative intraocular pressure (IOP; mmHg) and the incidence of macular holes (MH) were evidently lower in the 23-G group than in the 20-G group (all p<0.05). However, no statistical significances in the postoperative retinal reattachment rate or visual acuity improvement in the logarithm of the minimum angle of resolution (logMAR) were detected between the 23-G group and the 20-G group (both p>0.05). The meta-analysis further confirmed a shorter postoperative wound closure time, as well as a lower postoperative IOP and incidence of MH in the 23-G group than in the 20-G group (all p<0.05), while neither the postoperative retinal reattachment rate nor the visual acuity improvement in the logMAR showed statistical significance (all p>0.05).

Conclusions: Our retrospective comparative study of RD surgery using 20-G or 23-G techniques revealed a shorter postoperative wound closure time, as well as a lower postoperative IOP and incidence of MH in the 23-G group than in the 20-G group, confirming the superiority of 23-G vitrectomy over 20-G vitrectomy. This study provided a better option of 23-G vitrectomy for clinically managing RD.

No MeSH data available.


Related in: MedlinePlus