September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Intraoperative Optical Coherence Tomography (iOCT) Validates the Immediate Efficacy of External Diathermy in Sealing 25-gauge Sclerotomy Wounds
Author Affiliations & Notes
  • Denis Jusufbegovic
    Ophthalmology, University of Louisville, Louisville, Kentucky, United States
  • AHMET OZKOK
    Ophthalmology, University of Louisville, Louisville, Kentucky, United States
  • Shlomit Schaal
    Ophthalmology, University of Louisville, Louisville, Kentucky, United States
  • Footnotes
    Commercial Relationships   Denis Jusufbegovic, None; AHMET OZKOK, None; Shlomit Schaal, None
  • Footnotes
    Support  This project is supported by an unrestricted institutional grant from Research to Prevent Blindness (RPB)
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 5833. doi:
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      Denis Jusufbegovic, AHMET OZKOK, Shlomit Schaal; Intraoperative Optical Coherence Tomography (iOCT) Validates the Immediate Efficacy of External Diathermy in Sealing 25-gauge Sclerotomy Wounds. Invest. Ophthalmol. Vis. Sci. 2016;57(12):5833.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Small-gauge sutureless vitrectomy has become a preferred vitreoretinal surgical technique. Postoperative clinical assessment showed that 60% of 25-gauge sclerotomy wounds remain anatomically open 1 week after surgery. Wound closure can be facilitated by the use of external diathermy. The purpose of this study was to use iOCT for in-vivo validation of immediate closure of 25-gauge sclerotomy wounds in humans after the application external diathermy.

Methods : This was a prospective study of 7 eyes of 7 consecutive patients who underwent 25-gauge vitrectomy using the Lumera 700 and RESCAN 700 iOCT platform (Carl Zeiss Meditec, Germany). Following completion of surgical procedures, trocars were removed and wounds were clinically assessed for evidence of leakage. Real-time iOCT was used to image the sites of sclerotomy wounds in all cases before and after the application of external diathermy using a power of 30 Watts for 5 seconds. Anatomical characteristics of sclerotomy wounds were carefully assessed and documented.

Results : 14 sclerotomy wounds from 7 eyes were imaged using iOCT. At the end of surgeries, a clinically apparent wound leak was present in 2 of 14 sclerotomies; 14%. However, iOCT demonstrated that, in-fact, all 14 sclerotomy wounds were anatomically wide open following removal of trocars (Fig 1). After the application of external diathermy, all wounds were anatomically sealed (Fig 2). The 2 clinically leaking sclerotomies were also sealed following the application of external diathermy. None of the patients developed hypotony or any other post-operative complications.

Conclusions : iOCT demonstrated that despite no obvious wound leak, all 25-gauge sclerotomy wounds were anatomically open at the end of surgery. This promotes using a brief application of external diathermy on sutureless sclerotomy wounds to ensure their anatomical closure.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

 

iOCT Scan of 25-gauge Sclerotomy Wound. iOCT imaging of 25-gauge sclerotomy wound demonstrated a completely anatomically open surgical wound despite no evidence of clinically apparent wound leak.

iOCT Scan of 25-gauge Sclerotomy Wound. iOCT imaging of 25-gauge sclerotomy wound demonstrated a completely anatomically open surgical wound despite no evidence of clinically apparent wound leak.

 

iOCT Scan of 25-gauge Sclerotomy Wound After External Diathermy. A brief application of external diathermy resulted in a complete anatomical closure of the wound as demonstrated by iOCT imaging

iOCT Scan of 25-gauge Sclerotomy Wound After External Diathermy. A brief application of external diathermy resulted in a complete anatomical closure of the wound as demonstrated by iOCT imaging

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