gms | German Medical Science

Purpose: The evaluation of efficiency of the new generation of 27gauge pars plana vitrectomy (PPV) system in different pathologies.

Methods: PPV with the new generation 27 g system DORC^® (Ducth Ophthalmic Reserch Center) on 100 eyes (100 patients) in Augencentrum Köln. Indications: epiretinal membrane (n=68), idiopathic macula hole (n=18), diabetic vitreous hemorrhage (n=4), retinal detachement (4), diabetic proliferative tractive retinopathy (n=2), mouches volantes (n=4). Intra- and postoperative evaluation included anatomic reconstruction, visual rehabilitation, vitrectomy time, flow charts, intraoperative and postoperative complications’.

Results: The anatomical reconstruction success could be achieved for all indication groups. (100%). 76 eyes (70%) had a visual recovery of 3 and more lines. In none of the 100 cases a conversion in bigger gauge sizes has been necessary. All sclerotomies has been closed immediately after removal of the trockars. No hypotony (<10 mmHg) and no other intraoperative or postoperative complications have been detected.

Discussion: The flow and cutting effitiancy of the new 27 g high flow cutter system is high enough for secure and fast PPV for most indications. Main advantage of the 27 g system is the small scleral wound and most important the absolute secure closure of the sclerotomies immediately after end of the case. This could improve patient comfort, visual recovery, reduce postoperative irritation, hemorrhages, and even reduce endophthalmitis risk, which has to be evaluated in further studies. At the moment new designe of 27 g PPV cutters with improved flow are in the final evaluation for significant faster 27 g vitrectomy in the near future.