Clinical outcomes of 23-gauge vitrectomy may be better than 20-gauge vitrectomy for retinal detachment repair

OBJECTIVE: This study compared the clinical outcomes between 23-gauge (23-G) vitrectomy and 20-gauge (20-G) vitrectomy for the repair of retinal detachment (RD). METHODS: A retrospective comparative analysis of 135 RD patients was conducted between January, 2013 and September, 2014 in the Ophthalmology Department of the Affiliated Hospital of Weifang Medical College. The clinical outcomes of RD patients who underwent 23-G vitrectomy (n = 65) and 20-G vitrectomy (n = 70) were compared. A logistic regression analysis was used for prognostic factors in RD patients. A meta-analysis was performed using the comprehensive Meta-Analysis version 2.0 software. RESULTS: Baseline characteristics of RD patients between the 23-G group and the 20-G group were not significantly different (all p>0.05). The postoperative wound closure time was obviously shorter, and postoperative intraocular pressure (IOP; mmHg) and the incidence of macular holes (MH) were evidently lower in the 23-G group than in the 20-G group (all p<0.05). However, no statistical significances in the postoperative retinal reattachment rate or visual acuity improvement in the logarithm of the minimum angle of resolution (logMAR) were detected between the 23-G group and the 20-G group (both p>0.05). The meta-analysis further confirmed a shorter postoperative wound closure time, as well as a lower postoperative IOP and incidence of MH in the 23-G group than in the 20-G group (all p<0.05), while neither the postoperative retinal reattachment rate nor the visual acuity improvement in the logMAR showed statistical significance (all p>0.05). CONCLUSIONS: Our retrospective comparative study of RD surgery using 20-G or 23-G techniques revealed a shorter postoperative wound closure time, as well as a lower postoperative IOP and incidence of MH in the 23-G group than in the 20-G group, confirming the superiority of 23-G vitrectomy over 20-G vitrectomy. This study provided a better option of 23-G vitrectomy for clinically managing RD.