AIM:To compare the clinical effect of 23G and 25G+ vitrectomy for treatment of proliferative diabetic retinopathy(PDR).

METHODS: A total of 128 PDR patients(195 eyes)requiring vitrectomy in our hospital from November 2013 to May 2016 were randomly divided into 25G+ group and 23G group, 64 cases(97 eyes)in 25G+ group and 64 cases(98 eyes)in 23G group. In 25G+ group, patients were treated by 25G+ vitrectomy. In 23G group, patients were treated by 23G vitrectomy. The visual acuity, as well as intraocular pressure(IOP), iatrogenic injury and complications in two groups were recorded before and 1d, 1wk, 1mo after treatment. The operation time was compared between two groups.

RESULTS: The operation time in 25G+ group was lower than that in 23G group(P<0.05). The postoperative visual acuity at 1mo of two groups were improved compared with before surgery(P<0.01). However, visual acuity between two groups in the same period had no significant difference(P>0.05). IOP in 25G+ group before surgery had no significant difference compared with those after surgery at 1d,1wk, and 1mo(P>0.05), which it was the same in 23G group. IOP of two groups in the same period had no significant difference(P>0.05). The incidence rate of iatrogenic injury in 25G+ group was 4.1%, which was significant lower than that of 23G group(13.3%)(P<0.05). The incidence rate of complication in 25G+ group was 3.1%, which was significant lower than that of 23G group(11.2%)(P<0.05).

CONCLUSION: Both 23G and 25G+ vitrectomy are safe and effective treatment for PDR. However, 25G+ vitrectomy is the better choice for PDR for the shorter operation time, lower incidence rate of iatrogenic injury and fewer surgical complications.