A large randomized prospective trial comparing 27-gauge and 25-gauge vitrectomy systems for retinal procedures found comparable safety and efficacy between the two approaches. According to Mounir Benzerroug, MD, and colleagues from the department of ophthalmology at Rouen University Hospital in France, the study included 463 patients undergoing epiretinal membrane or macular hole surgery, with 227 randomized to 27-gauge vitrectomy and 236 to 25-gauge vitrectomy.

The researchers found no significant difference in total surgery time between the two groups (P=0.0911). Changes in best-corrected distance visual acuity and central macular thickness were similar between baseline and follow-up visits at 1 and 3 months. Intraoperative and postoperative complication rates were also comparable between 27-gauge and 25-gauge approaches.

Notably, the rate of sutureless vitrectomy was higher with the 27-gauge system, at 96.5% compared to 91.1% for 25-gauge (P=0.0170). This suggests the smaller gauge system may allow more procedures to be completed without sutures.

“These results suggest that 27-gauge vitrectomy probe is similar to 25-gauge probe in surgery time and complications, while decreasing the need for vitrectomy sutures,” the authors concluded. The findings indicate 27-gauge vitrectomy is a safe and effective alternative to 25-gauge vitrectomy for retinal surgeries, with potential benefits in terms of wound closure. However, longer-term studies may be needed to further evaluate outcomes between the two approaches.