Retrospective comparison of 25-gauge transconjunctival sutureless vitrectomy to 20-gauge vitrectomy for the repair of pseudophakic primary inferior rhegmatogenous retinal detachment

Retina. 2010 Nov-Dec;30(10):1678-84. doi: 10.1097/IAE.0b013e3181dd6da1.


Purpose: To compare anatomical and functional outcomes of 25-gauge transconjunctival sutureless pars plana vitrectomy (PPV) to standard 20-gauge 3-port PPV for the treatment of pseudophakic rhegmatogenous retinal detachments with inferior breaks.

Methods: Retrospective review of 78 consecutive eyes from 78 patients undergoing primary vitrectomy with a minimum of 3-month follow-up. Thirty patients underwent 25-gauge PPV and 48 patients underwent 20-gauge PPV from May 1993 to July 2008. Variables and outcome measures included patient demographics, retinal reattachment, best-corrected visual acuity, macular status, postoperative intraocular pressures, and surgical complications.

Results: Preoperative characteristics were similar in both groups. Single operation success rate was 25/30 (83.3%) for 25-gauge cases and 43/48 (89.6%) for 20-gauge cases (P = 0.50). Transient hypotony occurred in 6/30 25-gauge eyes and 1/48 20-gauge eyes (P = 0.01), whereas hypertension occurred in 10/30 25-gauge cases and 15/48 20-gauge cases. All but 2 eyes were attached at final follow-up (97%). At final follow-up, mean best-corrected visual acuity was 0.28 and 0.32 for the 25-gauge and 20-gauge groups (P = 0.74).

Conclusion: Outcomes of 20-gauge versus 25-gauge PPV for the management of pseudophakic inferior rhegmatogenous retinal detachments were not significantly different, with hypotony being the most significant postoperative complication in the 25-gauge group as compared with the 20-gauge group.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Conjunctiva
  • Cryosurgery
  • Female
  • Fluorocarbons / administration & dosage
  • Humans
  • Intraocular Pressure / physiology
  • Intraoperative Complications
  • Laser Coagulation
  • Male
  • Microsurgery / methods*
  • Middle Aged
  • Ocular Hypotension / etiology
  • Postoperative Complications
  • Pseudophakia / complications
  • Pseudophakia / surgery*
  • Retinal Detachment / diagnosis
  • Retinal Detachment / etiology
  • Retinal Detachment / surgery*
  • Retrospective Studies
  • Sulfur Hexafluoride / administration & dosage
  • Suture Techniques
  • Visual Acuity / physiology
  • Vitrectomy / methods*


  • Fluorocarbons
  • perflutren
  • Sulfur Hexafluoride