Purpose: To investigate the feasibility and efficacy of 25-gauge vitrectomy in the treatment of proliferative diabetic retinopathy (PDR). Methods: All patients underwent primary 25-gauge vitrectomy for simple vitreous hemorrhage (VH), fibrovascular proliferation (FVP), or tractional retinal detachment (TD), and were followed for more than 1 month. Final visual outcomes and intraoperative and postoperative complications were evaluated. Results: 167 eyes (138 patients) were used in this study, 65 eyes (39%) with VH, 66 eyes (40%) with FVP, and 36 eyes (21%) with TD. Measured using the mean logarithm of the minimum angle of resolution (logMAR), visual acuity (VA) significantly improved (p < 0.0001). Intraoperative iatrogenic retinal breaks developed in 19 eyes (11%). Concerning postoperative complications, VH in 36 eyes (22%), retinal detachment in 2 eyes (1%), and neovascular glaucoma 12 eyes (7%) were observed. No endophthalmitis developed. Conclusions: Twenty-five-gauge vitrectomy can successfully treat PDR. Clinical outcomes and complications are comparable to those of 20-gauge vitrectomy.

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