Purchase this article with an account.
O.P. Gupta, E.D. Weichel, M.S. Fineman, C.D. Regillo, R.S. Kaiser, A.C. Ho, J.A. McNamara, J.F. Vander; Postoperative Complications Associated With 25–Gauge Pars Plana Vitrectomy . Invest. Ophthalmol. Vis. Sci. 2006;47(13):4656.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To report postoperative complications in eyes undergoing 25–gauge pars plana vitrectomy (PPV).
A retrospective, single practice, interventional case series of 70 consecutive eyes that underwent 25–gauge PPV for various indications including, but not limited to epiretinal membrane, nonclearing vitreous hemorrhage, and idiopathic macular hole. Only primary, 3–port vitrectomies with a minimum postoperative follow–up of 12 weeks were included. Main outcome measures included Snellen visual acuity (VA), intraocular pressure (IOP), intraoperative complications, and postoperative complications.
The mean follow–up was 22 weeks (range, 12 to 38 weeks). The overall visual acuity improved from 20/368 (range, 20/25 – hand motions) preoperatively to 20/105 (range, 20/20 – counting fingers) postoperatively (p < 0.00005). All subgroups experienced statistically significant visual acuity improvement. Intraoperative complications included retinal tears observed in 2 eyes (2.9%). Postoperative complications included cataract progression in 17 eyes (42.5%), cystoid macular edema exacerbation in 5 eyes (7.1%), and retinal detachment in 1 eye (1.4%). Postoperative day 1 IOP measurements were statistically lower than preoperative IOP measurements in fluid–filled eyes (p = 0.031). There was no significant difference in preoperative and postoperative day 1 IOP measurements in eyes with intravitreal air (p = 0.30) or gas (p = 0.52). Sclerotomy sutures were required intraoperatively in five eyes (7.1 %) and postoperative day 1 hypotony was noted in 4 eyes (5.7%). All of these events were noted in fluid–filled eyes except for one case of postoperative day 1 hypotony with gas tamponade. No other postoperative procedures were required to address surgical–related issues such as hypotony other than the one eye with postoperative retinal detachment.
Intraoperative and postoperative complications were rare in this series of 25–gauge vitrectomy. Postoperative cataract progression and hypotony were the most common complications. Retinal tear or detachment was a rare complication in the intraoperative and postoperative setting. Fluid–filled eyes after 25–gauge 3–port pars plana vitrectomy appear to have a higher risk of wound leakage and postoperative hypotony compared to eyes with air or gas tamponade. No postoperative intervention was required for hypotony.
This PDF is available to Subscribers Only