Abstract
Purpose
To assess the incidence of iatrogenic retinal breaks (IRBs) and postoperative retinal detachments (RDs) in microincision vitrectomy surgery (MIVS) compared with 20-gauge (20 G) vitrectomy.
Methods
A comprehensive literature search was performed to find relevant studies and a meta-analysis of the IRBs and postoperative RDs rates after 20 G vitrectomy versus MIVS was conducted.
Results
Thirty-two studies were selected, including 14,373 eyes (6932 eyes in the 20 G group, 7441 eyes in the MIVS group). The meta-analysis demonstrated that the incidence of IRBs was significantly higher in 20 G vitrectomy vs. MIVS (OR = 2.22, 95% CI, 1.93−2.57, P < 0.00001) and in a subanalysis vs. 23 G MIVS (OR = 2.19, 95% CI, 1.87−2.56, P < 0.00001) and vs. 25 G MIVS (OR = 2.27, 95% CI, 1.62−3.18, P < 0.00001). Similar result was obtained in a subanalysis for macular surgery (OR = 2.44, 95% CI, 1.99−2.99, P < 0.00001), and also for sclerotomy-related IRBs (OR = 3.73, 95% CI, 2.55−5.44, P < 0.00001), but not for surgically induced posterior vitreous detachment-related IRBs (OR = 1.59, 95% CI, 0.89−2.84, P = 0.12). The incidence of postoperative RDs in 20 G vitrectomy was significantly higher compared to MIVS (OR = 1.72, 95% CI, 1.21−2.46, P = 0.003) and in a subanalysis vs. 23 G MIVS (OR = 2.45, 95% CI, 1.50−4.00, P = 0.0003), but not for 25 G MIVS (OR = 1.01, 95% CI, 0.63−1.64, P = 0.96). Similar result was obtained in a subanalysis for macular surgery (OR = 1.89, 95% CI, 1.26−2.85, P = 0.002).
Conclusion
This meta-analysis demonstrated that MIVS is associated with a lower risk of IRBs and postoperative RDs compared to 20 G vitrectomy.
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Acknowledgements
Funding
This work was supported by the National Natural Science Foundation of China (No. 81570875 to WSL), Welfare Technology Applied Research Program Fund of Science Technology Department of Zhejiang Province (No. LGF18H120002 to YHT) and Quzhou Science and Technology Project (No. 20172041 to GHC).
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Chen, G.H., Tzekov, R., Jiang, F.Z. et al. Iatrogenic retinal breaks and postoperative retinal detachments in microincision vitrectomy surgery compared with conventional 20-gauge vitrectomy: a meta-analysis. Eye 33, 785–795 (2019). https://doi.org/10.1038/s41433-018-0319-5
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DOI: https://doi.org/10.1038/s41433-018-0319-5
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