A pilot randomised controlled trial comparing the post-operative pain experience following vitrectomy with a 20-gauge system and the 25-gauge transconjunctival system

Wickham, L., Bunce, C., Kwan, A. S., Bainbridge, J. and Aylward, G. W. (2010) A pilot randomised controlled trial comparing the post-operative pain experience following vitrectomy with a 20-gauge system and the 25-gauge transconjunctival system. British Journal of Ophthalmology, 94 1: 36-40. doi:10.1136/bjo.2008.153411


Author Wickham, L.
Bunce, C.
Kwan, A. S.
Bainbridge, J.
Aylward, G. W.
Title A pilot randomised controlled trial comparing the post-operative pain experience following vitrectomy with a 20-gauge system and the 25-gauge transconjunctival system
Journal name British Journal of Ophthalmology   Check publisher's open access policy
ISSN 0007-1161
1468-2079
Publication date 2010-01
Year available 2009
Sub-type Article (original research)
DOI 10.1136/bjo.2008.153411
Volume 94
Issue 1
Start page 36
End page 40
Total pages 5
Place of publication London, United Kingdom
Publisher B M J Group
Collection year 2011
Language eng
Formatted abstract
Aims: To compare post-operative pain following 25-gauge (25G) and 20-gauge (20G) vitrectomy in the first week following surgery.
Methods: The study was a pilot randomised controlled trial with patients masked to the treatment allocation. Postoperative pain was assessed using both a visual scale and verbal pain scores for 1 week following surgery. Additional data collected included intraocular pressure (IOP), time taken to perform the surgical procedure, per-operative and post-operative complications, and dropout rates.
Results: Forty patients were recruited for the study: 21 randomised to 20G vitrectomy and 19 to 25G. In the first 12 h following surgery, presence of significant postoperative pain (defined as >1 cm on a visual analogue scale) was similar in both 20G (50%) and 25G (53%) patients. In the first week following surgery, 38 of the 527 scores (7.2%) were >1 (median 2.1, IQR 1.3-3) cm; however, there was evidence that ''significant pain'' was experienced more commonly in the 20G group. There was no statistical difference in the time taken to complete the surgical procedure, although in the 25G group the time from first incision to the start of vitrectomy was significantly shorter (p=0.043) and in the 20G group the time taken to complete the vitrectomy was less (p=0.047). Post-operative hypotony (IOP <6 mmHg) was observed in 25% of patients in the 25G group. No patients required additional surgery for hypotony.
Conclusion:
There was evidence that 25G resulted in less patient discomfort. However, pain was not a prominent feature in either group. We failed to find a significant advantage in 25G for patients or surgeons.
Keyword Pars-plana vitrectomy
Sutureless vitrectomy
Vitroretinal surgery
Endophthalmitis
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Available online 26 August 2009

Document type: Journal Article
Sub-type: Article (original research)
Collections: Faculty of Health and Behavioural Sciences -- Publications
Official 2011 Collection
 
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Created: Sun, 31 Jan 2010, 00:05:34 EST