COMPARISON OF CLINICAL OUTCOMES BETWEEN 27-GAUGE TRANSCONJUNCTIVAL NONVITRECTOMIZING VITREOUS SURGERY AND 25-GAUGE VITRECTOMY IN PATIENTS WITH EPIRETINAL MEMBRANE

Purpose: To compare the clinical outcomes and the rate of complications between 27-gauge transconjunctival nonvitrectomizing vitreous surgery (NVS) and 25-gauge transconjunctival sutureless vitrectomy surgery for idiopathic epiretinal membrane (ERM) removal. Methods: In this retrospective, comparative study, all consecutive phakic patients with an idiopathic ERM, that underwent 25-gauge standard vitrectomy (Standard-group), or 27-gauge NVS (NVS group), between May 2010 and January 2012, with a minimal follow-up of 12 months, were evaluated. Main outcome measures were best-corrected visual acuity (BCVA), optical coherence tomography (OCT) changes, and nuclear sclerotic cataract progression, at 6 months and 12 months after surgery. Results: Mean logarithm of the minimal angle of resolution BCVA improved significantly at all time points (P < .01,Tukey-Kramer test), in the standard group from 0.43 to 0.24 at 12 months and in the NVS group from 0.46 to 0.16, without significant difference between the 2 groups. Compared with baseline, at 6 and 12 months after treatment, central foveal thickness decreased significantly in both groups (P < .01,Tukey-Kramer test), with no significant difference between the 2 groups at any time point. At 12 months eyes undergoing standard vitrectomy surgery developed significantly more nuclear light scatter than in the lens of the NVS-group ones (79 % vs 12 %; P < .001, chi-square). At 12 months, the ERM recurred in 4% of eyes in the Standard-group and in 14% of eyes in the NVS-group, without significant difference between the 2 groups. Conclusions: The 27-gauge NVS is an effective method as vitrectomy in the treatment of ERM, with less progression of cataract.