AIM: To compare and observe the efficacy of 25G+ and 27G+ minimally invasive vitrectomy(MIVS)in the treatment of vitreoretinal diseases.

METHODS: A retrospective case-control study, 76 patients(76 eyes)with various vitreoretinal diseases treated in our hospital from December 2018 to January 2020 were selected and randomly divided into 25G+ group and 27G+ group underwent vitrectomy, and the operation time of the two groups of patients, as well as the changes of ETDRS visual acuity, intraocular pressure, and conjunctival edema 1d before surgery, 1d after surgery, and 1, 4, 12, and 24wk after surgery were compared and analyzed.

RESULTS: Compared with the 25G+ group, the 27G+ group had a longer vitrectomy time(27.17±5.95 vs 26.71±5.93min)and the total operation time was shorter than that of the 25G+ group(28.26±6.88 vs 30.37±6.68 min), but there was no significant difference between the two groups(t=0.322, P=0.748; t=-1.353, P=0.180). After vitrectomy, the visual acuity of the two groups was significantly improved compared with that before operation, but there was no significant difference between the two groups(P>0.05). Compared with the 25G+ group, the intraocular pressure fluctuation range of the 27G+ group at 1d(12.58±2.44 vs 10.56±3.21mmHg, t=2.943, P=0.004)and 1wk(13.48±2.85 vs 12.89±2.01mmHg, t=1.460, P=0.031)after the operation was low. Within 1wk after the operation, 7 eyes of transient hypotony occurred in the 25G+ group, but no hypotony occurred in the 27G+ group, indicating that the 27G+ MIVS can better stabilize postoperative intraocular pressure.

CONCLUSION: 27G+ MIVS and 25G+ MIVS are safe and effective in the treatment of vitreoretinal diseases. Compared with 25G+ MIVS, 27G+ MIVS can better stabilize intraocular pressure and reduce the occurrence of complications caused by postoperative hypotony.