열공망막박리에서 일차수술로서 20게이지와 23게이지 유리체절제술의 비교

Comparison Between 20-Gauge and 23-Gauge Vitrectomy System in Primary Vitrectomy for Rhegmatogenous Retinal Detachment

Purpose: The efficacy of 20-gauge and 23-gauge vitrectomy system was investigated in primary vitrectomy for rhegmatogenous retinal detachment. Methods: Eyes that underwent primary vitrectomy without scleral buckling for the treatment of rhegmatogenous retinal detachment were followed up at least 6 months and were reviewed retrospectively. Anatomic results, functional outcomes, operation time and complications were compared between 20-gauge and 23-gauge groups. Results: Among 59 eyes of 59 patients, the 20-gauge group had 29 eyes of 29 patients and 23-gauge group had 30 eyes of 30 patients. Anatomic success after a single operation was obtained in 23 eyes (79.3%) of the 20-gauge group and 28 eyes (93.3%) of the 23-gauge group. Recurrence occurred in 6 eyes (20.7%) in the 20-gauge and in 2 eyes (6.6%) in the 23-gauge group. Retinal reattachment in all of these eyes was obtained through reoperation. Visual acuity improved logMAR 0.2 or more in 19 eyes (65.5%) of the 20-gauge group and 20 eyes (66.7%) of the 23 gauge group (p=0.153, 0.215). The average operation time of the 23-gauge group was 80.2 minutes, which was significantly shorter than the 94.8 minutes of the 20-gauge group (p=0.008). Transient ocular hypertension and progression of lens opacity were the most common complications in the both groups. Conclusions: Twenty-three-gauge transconjuctival sutureless vitrectomy achieved outcomes comparable with 20-gauge vitrectomy, with significantly shorter operation time in repair of rhegmatogenous retinal detachment. It is considered as a viable alternative to 20-gauge vitrectomy in selected cases.