Purpose:
To investigate the in vivo incision architecture using Fourier Domain optical coherence tomography (FD-OCT) in 23-gauge and 25-gauge sutureless vitrectomy.
Methods:
A prospective observational study of 21 eyes of 21 patients that underwent 25-gauge (10 eyes) or 23-gauge (11 eyes) transconjunctival sutureless pars plana vitrectomy was performed. The three sclerotomies sites in each eye were analyzed by Corneal Adapter Model (CAM) RTVue FD-OCT (Optovue Inc, Fremont, CA) with wound cross-section images (longitudinal and transversal) on days one, seven, and 28 post-operatively. Wound length, thickness, and diameter were compared.
Results:
All patients completed 4 weeks of follow-up and all surgeries lasted less than 60 minutes. The 25-gauge mean incision length was 0.957 ±0.106 (range, 0.812-1.223), mean thickness of 0.023 ±0.03 mm (range, 0.019-0.028), and mean incision diameter was 0.237 ±0.016 mm (range 0.218-0.264). The 23-gauge mean incision length was 1.065 ±0.130 mm (range, 0.904-1.327), mean thickness of 0.059 ±0.018 mm (range, 0.040-0.095), and mean incision diameter was 0.364 ±0.021 mm (range 0.347-0.410). Mean incision angle was 31 degrees for 23-gauge and 22 degrees for 25-gauge. Wound thickness (P < 0.001), diameter (P < 0.001), and angle (p < 0.05) differences between 25-gauge and 23-gauge incisions were found to be statistically significant. No statistical difference was found in incision length among different quadrants or between 23- and 25-gauges.
Conclusions:
The 23-gauge and 25-gauge architectural sclerotomy wound construction was well visualized using FD-OCT. Statistical differences between the two gauges were observed in diameter and thickness throughout the study period.
Keywords: vitreoretinal surgery • imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) • retina