The study design was single center, retrospective, interventional case series. Two hundred consecutive eyes that underwent primary
vitrectomy for ERM (27-G
vitrectomy in 100 eyes and 25-G
vitrectomy in 100 eyes) were studied for 6 months. In all eyes, scleral tunnels were made using angle incisions, and air or gas exchange was performed.
RESULTS: There were no significant differences in age, spherical diopter power, as well as preoperative Early Treatment
Diabetic Retinopathy Study (ETDRS) score, central
retinal thickness (CRT), and intraocular pressure between the 27-G and 25-G groups. The proportions of simultaneous
cataract surgery (27-G vs. 25-G: 82% vs. 90%), air-filled eyes (99% vs. 98%), and scleral
wound suture at the end of surgery (0% vs. 0%) were not significantly different between two groups. The mean operation time for
vitrectomy was significantly (P = 0.0322) longer by 4 min for 27-G (37 min) compared to 25-G (33 min)
vitrectomy. Gain in ETDRS score was significantly (P = 0.0421) better in 27-G group (4.7 ± 8.1 letters) compared to 25-G group (1.1 ± 13.6 letters) at 1 month post-
vitrectomy, but not significantly different at 3 and 6 months (P = 0.0835 and 0.0569, respectively). Decrease in CRT was significantly (P = 0.0354) greater in 27-G group (-24.2 ± 50.0 μm) compared to 25-G group (-8.0 ± 48.6 μm) at 1 month post-
vitrectomy, but not significantly different at 3 and 6 months (P = 0.6059 and 0.1725, respectively). On postoperative day 1, hypotony (≤ 6 mmHg) was observed in 2 eyes in 27-G group and 6 eyes in 25-G group, while
ocular hypertension (≥ 25 mmHg) was found in 4 eyes in 27-G group and 11 eyes in 25-G group, with no significant differences between two groups. Postoperative complications requiring treatment occurred in one eye (
vitreous hemorrhage) in 27-G group, and in two eyes (
vitreous hemorrhage and
retinal detachment in one eye each) in 25-G group.
CONCLUSIONS: Although 27-G
vitrectomy requires operation time of 4 min longer compared to 25-G
vitrectomy for ERM surgery, using the 27-G system results in earlier recovery of visual acuity, CRT improvement and stabilized ocular pressure.