Objective To compare the efficacy of 23G and 20G vitrectomy for diabetic retinopathy. Methods Thirty-eight eyes of 33 patients with diabetic retinopathy who underwent primary vitrectomy were enrolled in this study. Twenty eyes of 18 patients underwent 23G microincision vitrectomy (23G group). Eighteen eyes of 15 patients underwent 20G vitrectomy (20G group). The followup ranged from 6 to 12 months. The surgical time, number of iatrogenic retinal tears, times of coagulation for hemorrhage, instrumental change for fibromembrane removal, intraocular pressure (IOP) at 1st, 2nd and 3rd days after surgery, postoperative complications, anatomic success rate, and best corrected visual acuity (BCVA) were observed. Results The mean surgical times were (63.5±21.7) and (83.9±27.5) minutes in 23G and 20G group which was a significant difference (t=2.55, P=0.02). The numbers of iatrogenic retinal tears were six and 14, while the mean times of coagulation were 71 and 104 in 23G and 20G group respectively. There were three and 12 eyes needing instrumental change for fibromembrane removal in 23G and 20G group with significant difference (χ2=10.58, P=0.001). At the 1st, 2nd and 3rd days after surgery, IOP were (10.2±2.0), (13.4±2.5), and (14.9±2.3) mm Hg (1 mm Hg=0.133 kPa) in 23G group, (16.5±2.9), (19.3±2.4), and (20.1±2.9) mm Hg in 20G group. Compared with each other, the differences were statistically significant (t=7.71, 7.41, 6.18; P＜0.01). There was one eye with intraocular hemorrhage, one eye with neovascular glaucoma (NVG), and one eye with retinal detachment (RD) in 23G group. There were two eyes with intraocular hemorrhage, two eyes with NVG, and one eye with RD in 20G group. Compared with each other, the differences were not statistically significant (χ2=0.49, 0.49, 0.01; P＞0.05). The anatomic success rates were 950% and 94.4% in 23G and 20G group without significant difference (χ2=0.01, P=0.94). There were no complications such as endophthalmitis or choroidal detachment. In 23G group, BCVA was ＜0.05 in one eye, 0.05 – 0.09 in five eyes, 0.1 -0.2 in 10 eyes, ≥0.3 in two eyes. In 20G group, BCVA was ＜0.05 in one eye, 0.05 - 0.09 in nine eyes, 0.1 -0.2 in six eyes, ≥0.3 in two eyes. Compared with each other, the differences were not statistically significant (χ2=2.70, P＞0.05). Conclusion 23G microincision vitrectomy is beneficial to shorten the operation time, reduce instrumental changes, decrease intraoperative complications, and enhance visual rehabilitation.
Citation： 刘海芸,宋正宇,刘堃,孙晓东,许迅. Comparison of 23G and 20G vitrectomy for diabetic retinopathy. Chinese Journal of Ocular Fundus Diseases, 2012, 28(2): 138-141. doi: Copy