Outcomes of 110 consecutive 25-gauge transconjunctival sutureless pars plana vitrectomies

Purpose: To evaluate the safety and efficacy of the 25-gauge transconjunctival vitrectomy system for a variety of vitreoretinal surgery indications at short-term follow-up. Methods: Retrospective study of consecutive interventional cases that underwent surgery performed by one surgeon using the Alcon 25-Gauge vitrectomy system, in Bordeaux University Hospital, from September 2004 to May 2006. Indications were epiretinal macular membrane (72 eyes), macular hole (24 eyes), and other diseases (14 eyes). Results: One hundred and ten eyes of 105 consecutive patients underwent surgery. None required conversion to 20-gauge vitrectomy or wound suture. One iatrogenic retinal break occurred intraoperatively. Two transient wound leaks, seven cases of hypotonia, one of chronic endophthalmitis, one of rhegmatogenous retinal detachment, one of retinal break, two recurrent intravitreal hemorrhages, and six cases of hypertonia were noted post-operatively. Three eyes required additional surgery. Mean overall visual acuity improved from 0.691 +/- 0.465 logMAR preoperatively to 0.476 +/- 0,492 logMAR at 1 month (p<0.0001). Visual acuity improvement was statistically significant for eyes with macular epiretinal membrane (p<0.0001) and macular hole (p=0.0158). The macular hole closure rate was 87.5%. Mean operative time was 25.91 +/- 10.94 min. Mean follow-up was 13.32 +/- 18.1 weeks. Thirteen eyes developed cataracts during the follow-up period. Conclusion: Vitrectomy with the 25-Gauge system appears to be relatively safe and particularly appropriate for macular surgery.