SHORT-TERM OUTCOMES OF HYBRID 23-, 25-, AND 27-GAUGE VITRECTOMY FOR COMPLEX DIABETIC TRACTIONAL RETINAL DETACHMENT REPAIR.

PURPOSE: To describe the short-term outcomes of complex diabetic retinal detachment repair using hybrid 23-gauge or 25-gauge vitrectomy instruments with a 27-gauge vitrectomy system.

METHODS: Retrospective, interventional, consecutive case series. Ten eyes of 10 patients undergoing hybrid pars plana vitrectomy for diabetic tractional retinal detachment were reviewed.

RESULTS: Combined use of 25-gauge and 27-gauge instrumentation was used in 8 of 10 eyes and combined use of 23-gauge and 27-gauge instrumentation in 2 of 10 eyes. In all cases, a 27-gauge vitreous cutter was used for membrane dissection and delamination. All eyes had successful anatomical reattachment at a mean follow-up of 207 ± 55 days. Snellen visual acuity improved from a mean of 20/822 preoperatively to 20/566 at the final follow-up (P = 0.55). Mean intraocular pressure remained stable at 13 ± 3.4 mmHg preoperatively to 13.6 ± 5.4 mmHg at the final follow-up (P = 0.76). No intraoperative or postoperative complications were encountered.

CONCLUSION: Concurrent use of the 27-gauge vitreous cutter with 23-gauge or 25-gauge instrumentation was effective during diabetic tractional retinal detachment repair. This hybrid technique was not associated with any significant intraoperative or short-term postoperative complications.