Multicenter survey of sutureless 27-gauge vitrectomy for primary rhegmatogenous retinal detachment: a consecutive series of 410 cases

  • Yoichiro Shinkai
  • Yusuke Oshima
  • Kazuhito YonedaEmail author
  • Jiro Kogo
  • Hisanori Imai
  • Akira Watanabe
  • Yoshitsugu Matsui
  • Kotaro Suzuki
  • Chie Sotozono
  • The 27G Vitrectomy Study Group
Retinal Disorders



To evaluate the surgical outcomes of the 27-gauge (G) vitrectomy system for the treatment of primary rhegmatogenous retinal detachment (RRD).


This retrospective consecutive series multicenter study involved a total of 410 eyes of 406 patients who underwent 3-port transconjunctival 27G pars plana vitrectomy (PPV) for RRD between November 2014 and December 2016 and who were followed for a minimum of 3 months postoperative. The main outcome measure was primary reattachment, with the secondary outcome measures being final reattachment, improvement of visual acuity (VA), intraocular pressure (IOP), intraoperative and postoperative complications, and surgery time.


Of the 410 treated eyes, primary reattachment was achieved in 392 (95.6%) and final reattachment was achieved in 410 (100%). In 226 eyes (55.1%) with macula-on RRD, the mean logarithm of the minimum angle of resolution (logMAR) VA improved from 0.16 ± 0.51 pre-surgery to 0.02 ± 0.14 post-surgery (P = 0.11). In 184 eyes (44.9%) with macula-off RRD, logMAR VA improved from 1.06 ± 0.77 pre-surgery to 0.26 ± 0.35 post-surgery (P < 0.001). Following surgery, the mean IOP was highest at 1 day (15.7 ± 7.0 mmHg) postoperative. In all eyes, surgery was concluded without the use of sutures or the need of conversion to a larger-gauge instrument. Although hypotony was observed in 14 (3.4%) of the 410 treated eyes at 1 day postoperative, it spontaneously resolved within 1 week without additional surgical intervention. No postoperative complications such as infectious endophthalmitis were observed throughout the follow-up period.


Our findings show that 27G PPV is both safe and effective for the treatment of primary RRD.


27-Gauge (G) Pars plana vitrectomy (PPV) Primary rhegmatogenous retinal detachment (RRD) Sutureless 



The authors wish to thank John Bush for reviewing the manuscript.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in this retrospective multicenter survey study involving human participants were in accordance with the ethical standards of the requirements for a parallel Institutional Review Board (IRB; Registration No. UMIN000031103) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Yoichiro Shinkai
    • 1
  • Yusuke Oshima
    • 2
  • Kazuhito Yoneda
    • 1
    Email author
  • Jiro Kogo
    • 3
  • Hisanori Imai
    • 4
  • Akira Watanabe
    • 5
  • Yoshitsugu Matsui
    • 6
  • Kotaro Suzuki
    • 7
  • Chie Sotozono
    • 1
  • The 27G Vitrectomy Study Group
  1. 1.Department of OphthalmologyKyoto Prefectural University of MedicineKyotoJapan
  2. 2.Oshima Eye ClinicTakatsukiJapan
  3. 3.Department of OphthalmologySt. Marianna University School of MedicineKawasakiJapan
  4. 4.Department of OphthalmologyKobe University Graduate School of MedicineKobeJapan
  5. 5.Department of OphthalmologyJikei University School of MedicineTokyoJapan
  6. 6.Department of OphthalmologyMie University Graduate School of MedicineTsuJapan
  7. 7.Department of OphthalmologyKeiyu HospitalYokohamaJapan

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