Comparison of visual function after epiretinal membrane removal by 20-gauge and 25-gauge vitrectomy

PURPOSE: To compare the efficacy and safety of 25-gauge vitrectomy with 20-gauge vitrectomy for macular pucker. DESIGN: Randomized clinical study. METHODS: Sixty,seven eyes (67 patients) with macular pucker were prospectively and randomly assigned to undergo 20-gauge vitrectomy or 25-gauge vitrectomy as a control group. Main outcome measurements consisted of best,corrected visual acuity (BCVA), mean induced astigmatism, total operation time, and postoperative complications. RESULTS: The mean BCVA at baseline and at one month and six months after surgery was 20/78, 20/62, and 20/42, respectively, in the 20,gauge group, and 20/85, 20/45, and 20/40 in the 25-gauge group. A significant difference in change in the logarithm of the minimal angle of resolution of BCVA between 20,gauge and 25,gauge was found at one month (-0.10 vs -0.269, P < .001), but not at six months (-0.327 vs -0.276, P > .01). CONCLUSIONS: If faster visual improvement is desired, 25,gauge vitrectomy may be preferable to 20-gauge vitrectomy for macular pucker.