Clinical Practice Study
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Pediatr. Feb 8, 2018; 7(1): 62-66
Published online Feb 8, 2018. doi: 10.5409/wjcp.v7.i1.62
Outcomes of transconjuctival sutureless 27-gauge vitrectomy for stage 4 retinopathy of prematurity
Parag K Shah, Vishma Prabhu, Venkatapathy Narendran
Parag K Shah, Vishma Prabhu, Venkatapathy Narendran, Department of Pediatric Retina and Ocular Oncology, Aravind Eye Hospital, Coimbatore, Tamil Nadu 641014, India
Author contributions: All authors equally contributed to this paper with regard to study conception and design, literature review and analysis, manuscript drafting, critical revision, and editing, and final approval of the final version.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of Aravind Eye Hospital.
Informed consent statement: The participating patients provided informed consent and gave permission for publication.
Conflict-of-interest statement: We have no financial relationships to disclose.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Correspondence to: Dr. Parag K Shah, DNB, Department of Pediatric Retina and Ocular Oncology, Aravind Eye Hospital, Avinashi Road and Postgraduate Institute of Ophthalmology, Coimbatore, Tamil Nadu 641014, India.
Telephone: +91-422-4360400 Fax: +91-422-2593030
Received: November 2, 2017
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
Research background

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.

Research motivation

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.

Research objectives

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.

Research methods

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.

Research results

The results of this study show that sutureless transconjuctival 27-gauge vitrectomy has good anatomical outcome in stage 4 ROP.

Research conclusions

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.

Research perspectives

In the future, 27-gauge vitrectomy has the potential to become the standard of care for all ROP-related lens-sparing vitrectomies.