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IATROGENIC RETINAL BREAKS IN 25-GAUGE VITRECTOMY UNDER AIR COMPARED WITH THE STANDARD 25-GAUGE SYSTEM FOR MACULAR DISEASES

Reibaldi, Michele MD, PhD*; Rizzo, Stanislao MD; Avitabile, Teresio MD*; Longo, Antonio MD, PhD*; Toro, Mario D. MD*; Viti, Francesca MD; Saitta, Andrea MD; Giovannini, Alfonso MD; Mariotti, Cesare MD

doi: 10.1097/IAE.0000000000000112
Original Study

Purpose: To evaluate the incidence rates of iatrogenic retinal breaks in eyes that underwent 25-gauge vitrectomy under air compared with 25-gauge standard vitrectomy for idiopathic macular holes or idiopathic epiretinal membranes.

Methods: In this retrospective, comparative interventional study, 435 eyes were enrolled. In all patients after core vitrectomy and epiretinal/inner limiting membrane peeling, complete vitrectomy of the base was performed, respectively under air (air group) or under fluid infusion (standard group).

Results: The number of eyes with iatrogenic retinal breaks was significantly lower in the air group than in standard group (4/197 and 16/238, 2% and 7%, respectively; P = 0.035). A postoperative retinal detachment developed in 2 eyes (1%) in the standard group, and in no eyes of the air group (0%). Factors related to the occurrence of retinal breaks were surgically induced posterior vitreous detachment (P = 0.006), standard vitrectomy (P = 0.023), and surgery for macular hole (P = 0.030).

Conclusion: The 25-gauge vitrectomy under air is associated with a lower incidence rate of retinal breaks compared with the standard 25-gauge vitrectomy.

This study showed that the 25-gauge vitrectomy under air significantly reduces the incidence of iatrogenic retinal breaks compared with the standard 25-gauge vitrectomy in eyes undergoing surgery for macular disease.

*Department of Ophthalmology, University of Catania, Catania, Italy;

Department of Ophthalmology, Santa Chiara Hospital, Pisa, Italy; and

Department of Ophthalmology, University of Ancona, Ancona, Italy.

Reprint requests: Michele Reibaldi, MD, PhD, Department of Ophthalmology, University of Catania, Via S. Sofia 78, Catania 95124, Italy; e-mail: mreibaldi@libero.it

S. Rizzo is a paid consultant for Alcon. The other authors have no financial/conflicting interests to disclose.

© 2014 by Ophthalmic Communications Society, Inc.