25-gauge macular surgery: results and complications.

Purpose: To report the safety and surgical outcome of 25-gauge transconjunctival sutureless vitrectomy for macular conditions.
Methods: In a single-center, retrospective, noncomparative case series, 160 eyes of 150 patients underwent 25-gauge vitrectomy for different macular conditions: 108 eyes for idiopathic macular pucker, 24 for idiopathic macular hole, and 28 for tractional diabetic macular edema. Main outcome measures were surgical time, preoperative and 1-day intraocular pressure (IOP), preoperative and 1-month, 3-month, and 6-month visual acuity, intraoperative and postoperative complications, anatomical results, and cataract progression. All patients were observed up for at least 6 months.
Results: Mean follow-up was 10 months (range, 6-20 months). Mean operative time +/- SD was 21 +/- 11 minutes. Mean 1-day IOP was 14 +/- 4 mmHg. No IOP was <8 mmHg on postoperative day 1. Mean overall preoperative visual acuity was 20/70, and mean overall postoperative visual acuity was 20/40 (P <or= 0.001). Sixty percent of patients gained >or=2 Snellen lines of visual acuity at 1 month; 74%, at 3 months; and 67%, at 6 months (P <or= 0.001, all times). There were no intraoperative complications. Three percent of eyes had complications during follow-up. Twenty-five percent of phakic eyes presented with a significant cataract at the 6-month follow-up.
Conclusions: 25-Gauge vitrectomy is a safe and effective procedure for macular surgery. The absence of intraoperative complications and relatively low rate of postoperative complications suggest that this technique is safe and effective for treating macular conditions.