Published online Feb 8, 2018. doi: 10.5409/wjcp.v7.i1.62
Peer-review started: November 2, 2017
First decision: November 30, 2017
Revised: December 3, 2017
Accepted: December 14, 2017
Article in press: December 14, 2017
Published online: February 8, 2018
Retinopathy of prematurity (ROP) vitrectomy is challenging due to the altered and more compact structures in a pediatric eye. Hence, there is a need to invent smaller vitrectomy instruments to make the outcome of this surgery better. 27-gauge vitrectomy being the smallest gauge available commercially could have the most benefit in the pediatric age group.
27-gauge instruments are smaller in size and have capability of high speed cutting, which is ideal for pediatric eyes. Hence, this study was conducted to examine the feasibility of this instrument in ROP surgery.
The main research objective was to assess the feasibility of 27-gauge vitrectomy for ROP and to examine if the ease of surgery and surgical outcomes could be bettered.
27-gauge vitrectomy has been reported mainly in adult eyes. Very few studies have explored its use in the pediatric age group and especially in ROP. This is one of the few studies which tried 27-gauge vitrectomy exclusively in stage 4 ROP.
The results of this study show that sutureless transconjuctival 27-gauge vitrectomy has good anatomical outcome in stage 4 ROP.
27-gauge vitrectomy is beneficial for pediatric eyes. It is safe and effective. This study shows that smaller gauge instruments are most suitable for lens-sparing vitrectomy in ROP where the surgical space is very limited with the ever looming danger of damaging the lens anteriorly and the retinal posteriorly. Even with the limited surgical space, it become easier to maneuver with 27-gauge instruments without damaging the critical structures.
In the future, 27-gauge vitrectomy has the potential to become the standard of care for all ROP-related lens-sparing vitrectomies.