Abstract
Purpose: :
To describe the postoperative outcome of 23-gauge vitrectomy without eye padding.
Methods: :
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.
Results: :
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.
Conclusions: :
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.
Keywords: vitreoretinal surgery • wound healing • clinical (human) or epidemiologic studies: outcomes/complications