Modified 23-gauge vitrectomy system for stage 4 retinopathy of prematurity

Wei Chi Wu*, Chi Chun Lai, Rey In Lin, Nan Kai Wang, An Ning Chao, Kuan Jen Chen, Tun Lu Chen, Yih Shiou Hwang

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

30 Scopus citations

Abstract

Objective: To evaluate the outcome of a novel, modified 23-gauge vitrectomy system in the treatment of stage 4 retinal detachment in retinopathy of prematurity. Methods: Consecutive patients with stage 4 retinopathy of prematurity treated with modified 23-gauge vitrectomy were included in this medical record review. Major novel modifications included the use of a small infusion cannula, a 20-gauge blade for the creation of sclerotomies in the pars plicata, and a 23-gauge endoilluminator and vitreous cutter. Conjunctival dissection and suturing of sclerotomies were performed using this modified 3-port, 23-gauge vitrectomy technique. Anatomic success and surgical complications were analyzed. Results: Twenty-six eyes of 17 patients were included and analyzed. The mean (SD) gestational age was 28.0 (2.5) weeks, and the mean birth weight was 1199 (449) g. Mean postmenstrual age at the time of vitrectomy was 40.5 (3.0) weeks. Overall, 20 eyes (77%) achieved retinal attachment in a single operation, and 23 eyes (88%) achieved retinal attachment after multiple procedures. Postoperative complications included disc dragging (5 eyes [19%]), cataracts (4 [15%]), glaucoma (2 [8%]), persistent vitreous hemorrhage (1 [4%]), and posterior synechia (1 [4%]). Conclusions: This 23-gauge vitrectomy system seems to be a safe and effective approach for treatment of stage 4 retinopathy of prematurity. This modified system combines the benefits of 20- and 23-gauge vitrectomy and offers safer insertion of infusion cannulas in smaller eyes, more working space in pediatric eyes, a cutting port that is closer to the retina, and a faster cutting speed with less vitreous traction during the operation.

Original languageEnglish
Pages (from-to)1326-1331
Number of pages6
JournalArchives of Ophthalmology
Volume129
Issue number10
DOIs
StatePublished - 10 2011

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