Pars plana vitrectomy for the repair of primary, inferior rhegmatogenous retinal detachment associated to inferior breaks. A comparison of a 25-gauge versus a 20-gauge system

Graefes Arch Clin Exp Ophthalmol. 2013 Feb;251(2):485-90. doi: 10.1007/s00417-012-2059-8. Epub 2012 May 17.


Background: To compare anatomical, functional outcomes and complications of high-speed 25-gauge (G) pars plana vitrectomy (PPV) versus 20-G PPV for the management of primary inferior rhegmatogenous retinal detachment (RRD) associated to inferior breaks/holes.

Methods: Eighty-five eyes from 85 patients with a minimum follow-up of 3 months were retrospectively evaluated. Forty-one patients underwent 25-G and 44 patients underwent 20-G PPV. All patients underwent PPV with fluid-air exchange, sulfur hexafluoride (SF6) 20 % gas tamponade and laser or cryo retinopexy.

Results: The mean follow-up interval was 6.51(± 2.32) and 6.63 (± 2.58) months in the 25-G and 20-G groups respectively. Single-operation success rate was 92.7 % for the 25-G group and 81.8 % for the 20-G group (P = 0.24). Post-operative hypotony was observed in no case. Redetachment occurred in 3 eyes operated on with 25-G and in 8 eyes operated on with 20-G system. All retinas were attached at final follow-up. Logarithm of the minimum angle of resolution visual acuity significantly improved from 0.69 ± 0.76 to 0.33 ± 0.37 in the 25-G and from 0.47 ± 0.59 to 0.21 ± 0.28 in the 20-G group (P = 0.0007 and P < 0.0001 respectively).

Conclusions: High-speed PPV and SF6 gas tamponade using either 25-G or 20-G PPV system, yields similar single operation anatomical success rates for the repair of uncomplicated, primary inferior RRDs associated to inferior breaks.

Publication types

  • Comparative Study

MeSH terms

  • Cryosurgery
  • Endotamponade
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Microsurgery / methods*
  • Middle Aged
  • Pseudophakia / complications
  • Retinal Detachment / physiopathology
  • Retinal Detachment / surgery*
  • Retinal Perforations / physiopathology
  • Retinal Perforations / surgery*
  • Retrospective Studies
  • Sulfur Hexafluoride / administration & dosage
  • Treatment Outcome
  • Visual Acuity / physiology
  • Vitrectomy / methods*


  • Sulfur Hexafluoride