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S. E. Eccles Brown, R. G. Lane; A Novel Method for Constructing 23 Gauge Vitrectomy Wounds: A UBM Study With Clinical Outcomes. Invest. Ophthalmol. Vis. Sci. 2010;51(13):1751.
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© ARVO (1962-2015); The Authors (2016-present)
To describe a novel method for wound construction using angled 23 gauge trochars and to list clinical outcomes using this technique in a consecutive case series.
Alcon 23 gauge trochars were angled at 30 degrees and inserted into a rabbit eye model. Scleral tunnel wound lengths were measured by ultrasound biomicroscopy (UBM). Wound lengths were compared between angled Alcon 23 gauge trochars, straight (unmodified) Alcon 23 gauge trochars and DORC 23 gauge "one step" trochars. This technique was then used prospectively in a case series. Patient records were reviewed for postoperative day (POD) 1 IOP, choroidal effusion, need for re-operation and other adverse complications related to trochar wound design. Cases involving vitrectomy with scleral buckle or glaucoma drainage implant were excluded.
Scleral tunnel lengths measured 1.5mm for straight (unmodified) Alcon 23 gauge trochars, 1.8mm for angled Alcon 23 gauge trochars and 1.9mm for DORC 23 gauge "one step" trochars. For the case series, 43 cases were identified that used the new, modified Alcon 23 gauge trochars and met inclusion criteria. Mean POD1 IOP was 15.7, median 14, range 4 to 36. There was one case of POD1 hypotony (defined as IOP <=4) and one low choroidal effusion, all of which resolved by 1 week without further intervention. There were no cases requiring return to the OR for resuturing of wounds.
Modification of Alcon 23 gauge trochars is a safe method and results in a low incidence of complications.
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