Comparison of 23G and 25G + vitrectomy for treatment of proliferative diabetic retinopathy

Objective To compare the outcomes of 23G and 25G plus (25G+) vitrectomy in treatment of proliferative diabetic retinopathy (PDR).Methods This is a prospective randomized study.Fifty-seven PDR patients (75 eyes) with symptoms requiring vitrectomy were randomly divided into 23G vitrectomy group (30 patients,39 eyes) and 25G+ vitrectomy group (27 patients,36 eyes).Visual acuity,intraocular pressures,ophthalmoscopy,B-scan ultrasound was examined before surgery.The follow-up period was 10.0 (23G group) and 8.5 months (25G+ group) respectively.Intraoperative complications,operation time,postoperative visual acuity,intraocular pressure,postoperative complications and postoperative ocular conditions were analyzed.Results The mean surgical times were (53.35± 7.42)minutes and (49.16±5.17) minutes in 23G and 25G+ group respectively,and the difference was significant (t=4.37,P＜0.05).Iatrogenic injuries occurred in 11 eyes (28.21％) and 5 (13.89％) eyes in 23G and 25G + group respectively,and the difference was significant (x2 =4.93,P＜0.05).The postoperative visual acuity of 23G and 25G+ group were improved compared to before surgery (x2=16.81,18.29; P＜0.05).At last follow-up,there was 25 eyes and 24 eyes with visual acuity ≥ 0.05 in 23G and 25G+ groups respectively,and the difference was not significant (x2 =0.13,P＞0.05).Hypotony was detected in 7 and 3 eyes at the third postoperative day in 23G and 25G+ group respectively,and the difference was significant (x2 =5.67,P＜0.05).Conclusion 25G+ vitrectomy is a safe and effective treatment for PDR with shorter surgery time and fewer surgical complications. Key words: Diabetic retinopathy/surgery;  Surgical procedures, minimally invasive;  Vitrectomy