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D. M. Stanescu, M. Sebag; Sutureless Transconjunctival Sclerotomy for Pars Plana Vitrectomy : Outcomes of 180 Cases. Invest. Ophthalmol. Vis. Sci. 2007;48(13):5719.
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To describe a new type of 20-gauge trans-conjunctival pars plana sclerotomy .The study design was a retrospective study, including 181 patients who underwent pars plana vitrectomy at the Dept of Ophthalmology, University Medical Hopital NotreDame, Montreal, between 2004 and 2006
Chart review of 181 consecutive patients (181 eyes and 543 sclerotomies) who underwent trans-conjunctival sclerotomy (TCS ) by one surgeon (M.S.) for various vitreo-retinal conditions : idiopathic epiretinal membrane, idiopathic macular hole,tractional retinal detachment, rhematogen retinal detachment,nonclearing vitreous hemorrhage, proliferative vitreous retinopathy, retained lens fragment, dropped nucleus, silicone oil removal and endophtalmitis. Main outcome measures included time of setting, number of sutures and counter-incision required per eye and per sclerotomy, patient demographics, diagnoses, and types of procedures, postoperative intraocular pressure and both intraoperative and postoperative complications.
There were 71 women and 110 men. The mean age was 59.63 years ( range from 19 to 89 years).Mean opening time was 68 seconds. The suture rate per eye was 20% ( 38 eyes out of 181) The suture rate per sclerotomy was 9%.(49/543) Thirty four eyes did not require counter incision techniques.The counter-incision rate per sclertomy was 48%(266/543).Mean IOP was 17.7 mmHg. In total indications for surgery were rhematogen retinal detachment (106),mixed retinal detachment (2), tractional retinal detachment (3), endophthalmitis (2), dyalisis (1), removal of silicone oil (18), vitreous hemorrhage (14), epiretinal membrane (15), subluxated lens (3), luxated lens (6), macular hole (7) and one combined retinal detachment and phakoemulsification (3).Two subgroups were analyzed. Group 1 includes procedures with injection or removal of silicone oil and fragmatome. Group 2 encompass all other procedures except the one with silicone oil or fragmatome.We found divergent results according to subgroup classification and these results are showed and discussed below.
This novel technique of 20G trans-conjunctival pars-plana vitrectomy allow watertight sutureless sclerotomies. It is safe, reproductible, easy to learn and perform and brings all the advantages of suturless surgery.
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