Effect of Partial Air Fluid Exchange on Immediate Post-operative Sclerotomy Wound Competence in Microincisional Vitrectomy

Abstract

Purpose: : To compare the rate of post-operative sclerotomy wound leakage following transconjunctival 25 -gauge vitrectomy in eyes with a partial air-fluid exchange versus no air tamponade

Methods: : Retrospective, consecutive case series of all epiretinal membrane cases that underwent transconjuntival 25 gauge-vitrectomy at a single institution over a three year period. Operative reports were reviewed. All cases were performed using the same 25-gauge system. In each case the surgeon sutured a sclerotomy site when a clinically significant leak was evident following removal of the trocar cannulas.

Results: : A total of 181 eyes were identified. 35% (14/40) of eyes without air tamponade had one or more sclerotomies sutured at the conclusion of the case. 12% of eyes (17/141) in which a partial air fluid exchange was performed necessitated suturing of one or more sclerotomies sutured at the conclusion of the case. Fisher’s exact test showed a statistically significant difference in the number of sclerotomy site leaks between the two groups (p= 0.0016).

Conclusions: : Partial air-fluid exchange at the conclusion of 25-gauge transconjunctival vitrectomy cases led to a statistically significant reduction of sclerotomy wound leaks necessitating post-operative suturing when compared to fluid filled eyes.

Keywords: vitreoretinal surgery • endophthalmitis • wound healing