Purchase this article with an account.
Marcelo Zas, Carina Rinaudo, Lucas Adamo, Gaston Gomez Caride, Pablo Chiaradia; 23-Gauge Transconjunctival Sutureless Pars Plana Vitrectomy In Different Posterior Segment Diseases. Complications, Visual Outcomes And Results: An Update. Invest. Ophthalmol. Vis. Sci. 2013;54(15):3335.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To assess the effectiveness, visual outcomes and results of the transconjunctival sutureless pars plana vitrectomy for several posterior segment diseases in our Retina Section.
A retrospective chart review of 125 consecutive 23-gauge vitrectomy cases done by the vitreoretinal surgeons of our staff. All surgeries were performed using the two-step 23-gauge system. The indications for surgical intervention were proliferative diabetic retinopathy (PDR) (n=46), rhegmatogenous retinal detachment (RRD) (n=28, 20 pseudophakic and 8 phakic), traumatic retinal detachment and PVR (n=13), macular epiretinal membrane (MEM) (n=17), macular hole (MH) (n=7), endophthalmitis (n=3), and vitreous hemorrhage secondary to branch retinal vein occlusion (BRVO) (n=11). All patients had at least a 6-month follow-up. Main outcome measures included visual acuity (VA), intraocular pressure (IOP), OCT pre and post-op, and operative complications.
Mean overall VA was counting fingers (range light perception to 0.2) preoperatively and 0.3 (range 0.1 to 0.7) postoperatively (p=0.001). Statistically significant VA improvement was observed in eyes with PDR, RRD, MEM, MH endophthalmitis, BRVO and PVR cases. Mean IOP was 16 mmHg (range 10-26 mmHg) preoperatively and 16.4 mmHg (range 10-21 mmHg) at 2 months postoperatively. Worrisome complications were 5 cases of hypotony occurrying on day 1, 1 case of endophthalmitis and 4 cases of pseudophakic retinal detachment that recurred.
In this updated series we have found that 23-gauge transconjunctival sutureless vitrectomy is an effective and safe surgical technique in the management of vitreoretinal diseases. This minimally invasive and completely sutureless technique appears to decrease the operating time and improve patient comfort. A comparison with 25 and 27-gauge technique is needed.
This PDF is available to Subscribers Only