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A. Ortiz Gonzalez, J. Jimenez-Sierra, V. Morales-Canton, M. Martinez-Castellanos, J. De La Luz-Osnaya; Is Postoperatory Eye Padding Necessary After Small Gauge Vitrectomy?. Invest. Ophthalmol. Vis. Sci. 2010;51(13):2574.
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To describe the postoperative outcome of 23-gauge vitrectomy without eye padding.
Were included 217 eyes who underwent pars plana vitrectomy (PPV) from May to November 2009. All the procedures were performed with 23 gauge vitrectomy with Accurus Surgical System (Alcon)® and visualization with precorneal contact lens with topical anesthesia or peribulbar block. All adult patients with uneventful vitrectomy were included. After surgery the eye was left open without patch; the cases that required face down position a clear translucent shield was use. All the eyes received same antibiotic and anti-inflammatory drop therapy. We measured corneal epithelial defects with fluorescein staining and conjunctival inflammation in the first 24 hrs.
The indications of PPV were: 173 proliferative diabetic retinopathy, 13 regmatogenous retinal detachment with no scleral buckle, 12 macular hole, 7 epiretinal membrane, 6 vitreous hemorrhage for other causes than PDR, 3 lens luxation after phaco, 2 IOL luxation and one vitreous biopsy. After surgery, 2 patients presented discharge in lids and conjunctiva, 6 patients mild inferior punctate keratopathy. No other findings were recorded. The assessment of comfort is notoriously difficult and inaccurate, but 58 patients complain transient photofobia, 12 patients mild pain, 3 foreign body sensation and one transient diplopia.
Not padding the aye after an uneventful small gauge vitrectomy seems to be safe, with the advantage that topical treatment should be started right a way. The patients with special position after surgery that used a clear shield without a pad had no reduction.
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