Abstract
Purpose: :
Postoperative IOP is an indirect measure of wound competency following 25 gauge, transconjunctival, sutureless vitrectomy (TSV). We compared the first and second postoperative IOP measures in eyes operated on for vitreous hemorrhage (VH) or epiretinal membranes (ERM) with either the B&L or Alcon system of microcannulars and trocars in treated patients.
Methods: :
Retrospective chart review of eyes with VH or ERM that underwent 25 gauge TSV vitreous surgery over an 18 month period operated on by a single surgeon. The system used was determined by the facility, not case complexity or other ocular/medical factors. We excluded eyes with glaucoma or ocular hypertension. The data was analyzed using the paired two tailed t-test.
Results: :
113 patients were enrolled. The B&L was used to treat 37 patients with VH and 20 with ERM; the Alcon treated 38 patients with VH and 18 with ERM. There was no ophthalmic or demographic difference between the groups. There was a statistical trend of higher postoperative IOPs with the B&L. B&L patients had a mean increase in IOP of 0.0351 +8.03 (SD) mmHg on the first visit, Alcon patients had a mean decrease in IOP of 2.77 +7.32(SD) mmHg on the first visit ( p=0.057). On the second visit (within one week postoperative) the B&L eyes had a mean decrease in IOP of 1.461 +3.49 (SD) mmHg, Alcon patients had a mean decrease in IOP of 2.05 +7.33(SD) mmHg on the second visit (p=0.598). B&L patients treated for VH had higher pressures for the first visit than the Alcon, which was significant (p=0.026), but the second visit was not (p=0.228), neither were the B&L’s higher IOPs for both ERM postoperative visits (p=0.809, p=0.261).
Conclusions: :
There is a pattern of higher pressures post-operatively with the B&L as compared to the Alcon system in patients who have been treated for VH or ERM reaching statistical significance for eyes with VH. This may suggest a better wound competency with the Millennium system. Implications for risk of infection or bleeding are suggested.
Keywords: vitreoretinal surgery