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Francesco Boscia, Gianluca Besozzi, Luigi Sborgia, Nicola Recchimurzo, Fabio Mininni, Giuseppe Lippolis; Cauterization For Leaking Sclerotomies After Small-gauge Transconjunctival Pars Plana Vitrectomy (Tsv). Invest. Ophthalmol. Vis. Sci. 2011;52(14):2127.
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To evaluate efficacy and safety of bipolar cauterization to ensure wound closure of leaking sclerotomies in small-gauge transconjunctival sutureless pars plana vitrectomy (TSV)
Sixty-seven eyes of 67 patients (mean age 61.8 years; 43 men, 24 women) with a variety of vitreoretinal disorders were enrolled and monitored for a mean follow-up time of 19.44 weeks (range 12-53 weeks). A total of 201 sclerotomies showing leakage at the end of the procedure were included. There were thirty-six 25g sclerotomies, and one-hundred-sixty-five 23g sclerotomies. Vitreous was removed entirely with triamcinolone staining. At the end of the procedure, bipolar cauterization was applied on sclerotomy including conjunctiva and sclera. Intraoperative persistent leakage and number of sutured sclerotomies were recorded. Postoperative Seidel positivity, conjunctival blebs, intraocular pressure hypotony (<6 mmHg), and complications were evaluated at hour 6, day 1 and 3.
Only 7/201 (3.5%) sclerotomies needed sutures because of intraoperative leakage even after cauterization. Postoperatively, no leakage and/or conjunctival blebs was observed. In 4/67 (6%) cases an early hypotony (hour 6) occurred, with a positive Seidel in 1/201 (0.5%) case, that needed suturing. Mean intraocular pressure did not vary significantly at any postoperative timepoint. No endophthalmitis was recorded
Bipolar cauterization of sutureless sclerotomies is a simple, safe and effective method to obtain complete sclerotomy closure, without significant postoperative complications.
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