الفهرس 
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Abstract
The aim of this work was to compare the safety and effectiveness of diabetic vitrectomy using either a 27-gauge system or 23-gauge system.
The study was carried out on 40 eyes of diabetic patient. All of them were indicated for vitrectomy because of diabetic retinopathy. Twenty patient were operated upon using the 27-gauge system and the other twenty with the 23-gauge one.
Patients were subjected to detailed ophthalmic examination including visual acuity, anterior segment examination and detailed fundus examination.
Operative data regarding the duration of surgery, intraoperative events, tamponade used, incidence of iatrogenic breaks were recorded. Also, postoperative data such as intraocular pressure (IOP), postvitrectomy hemorrhage were also recorded.
In each group 8 cases (40%) had vitreous hemorrhage and 6 cases (30%) had vitreous hemorrhage with fibrovascular prolferations. Only one case with fibrovascular proliferation (5%) was subjected to 27-gauge vitrectomy. In the first group 4 cases (20%) were indicated for surgery for tractional retinal detachment compared to 6 cases (30%) with the same indication in the second group. One case with combined tractional rhegmatogenous retinal detachment was subjected to 27-gauge vitrectomy.
In the 27-gauge group, the procedure took a duration of range from 30 to 130 minutes, while in the 23-gauge group it took from 32 to 90 minutes.
Epiretinal membranes either causing retinal detachment or not were present in 12 cases (60%) in both groups. Complete removal of the membranes was achieved in 8 cases (40%) in the 27-gauge group compared to 6 cases (30%) in the 23-gauge group.
No iatrogenic breaks were accidentally created in 13 cases (65%) in the 27-gauge group compared to 8 cases (40%) in the 23-gauge group.
The duration of silicone oil injection in the 4 cases of the 27-gauge group that required silicone oil injection ranged from 135 to 182 seconds, while in the 8 cases of the 23-gauge group it ranged from 58 to 90 seconds.
The new 27-gauge systems offered a less incidence of iatrogenic breaks compared to the standard 23-gauge system while it had some limitations for example longer duration of silicone oil injection.