Comparison of clinical outcomes between 23-gauge and 20-gauge vitrectomy in patients with proliferative diabetic retinopathy

Purpose: The purpose of this study was to compare the clinical outcomes and complications between 23-gauge transconjunctival sutureless vitrectomy and 20-gauge vitrectomy in patients with proliferative diabetic retinopathy. Methods: This is a retrospective comparative study comprising 101 eyes from 90 consecutive patients who had diabetic vitrectomy due to nonclearing vitreous hemorrhage. Thirty-five eyes underwent 23-gauge transconjunctival sutureless vitrectomy, and 66 eyes underwent 20-gauge vitrectomy. Main outcome measures were best-corrected visual acuity, intraocular pressure, and incidence of intraoperative and postoperative complications with at least 6 months of follow-up. Results: Best-corrected visual acuity of both groups at postoperative months 1, 3, and 6 significantly improved from the preoperative best-corrected visual acuity (P < 0.0001, respectively). There was no difference for best-corrected visual acuity between the 2 groups at each follow-up period (P > 0.05, respectively). Intraocular pressure of the 23-gauge group at postoperative Day 1 and Week 1 was less than the preoperative intraocular pressure (P < 0.0001 and 0.017). Operating time of the 23-gauge group was shorter than the 20-gauge group (P < 0.0001). There was no difference in the incidence of intraoperative and postoperative complications except transient postoperative hypotony, which occurred in 8 eyes (22.9%) from the 23-gauge group (P < 0.0001). Conclusion: Twenty three-gauge transconjunctival sutureless vitrectomy appears to be as effective for proliferative diabetic retinopathy as 20-gauge vitrectomy.