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Marwan A Abouammoh, Mohammad Abouammoh, Jeffrey Gale, J Fernando Arevalo, Sanjay Sharma; A novel technique for securing sclerotomies in 20-gauge transconjunctival pars plana vitrectomy: Surgical outcomes and complications in 529 consecutive cases. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):5111.
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© ARVO (1962-2015); The Authors (2016-present)
To describe a novel technique for securing sclerotomies after 20-gauge transconjunctival pars plana vitrectomy and determine the efficacy, and short-term safety in various vitreoretinal diseasesA novel surgical technique is described.
A novel surgical technique is described. A retrospective chart review of consecutive cases that underwent 20-gauge transconjunctival pars plana vitrectomy with sclerotomy hydration was conducted. Parameters assessed were patients’ demographics, ophthalmic history and examination, post-operative intraocular pressure (IOP) and gas/air fill, initial and final best corrected visual acuity (BCVA), and intra- and early postoperative complications. The main outcome measures included IOP (by Goldman applanation), intraocular gas bubble size in postoperative Day 1, and early postoperative complications. Secondary outcomes included postoperative visual acuity at 1-month postoperative visit.
Five-hundred and twenty-nine eyes were evaluated. Mean gas/air fill and mean IOP were 75.1% (±16.8) and 14.8 mmHg (±4.6) on post-operative day 1. Seven eyes (1.32%) had hypotony (IOP<6mmHg) on Day 1, which normalized in all eyes by Day 7 (p=0.0083). On post-operative day 7, mean IOP was 17.1 mmHg (±8.6). Hypotony was associated with a preoperative diagnosis of retinal detachment (P=0.022), and with silicone oil tamponade (P=0.017). Mean BCVA was (1.2±1.01) (LogMAR±SD) preoperatively and (0.8±0.78) post-operatively at 1-month follow-up visit (p <0.0001). Twenty-seven cases had intra- or postoperative complications (5.1%). Rate of complications was not associated with type of tamponade (p =0.076).
Twenty-gauge transconjunctival sutureless vitrectomy with sclerotomy hydration at the conclusion of surgery appears to be safe with a low rate of hypotony and complications, and good final visual outcome.
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