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J. J. Chieh, A. H. Rogers, C. C. Robinson, T. W. Wiegand, C. Baumal, E. Reichel, J. S. Duker; Complications of 23-Gauge Transconjunctival Vitrectomy Surgery. Invest. Ophthalmol. Vis. Sci. 2008;49(13):2053.
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To report the safety profile of the Alcon 23-gauge single step preloaded transconjunctival vitrectomy system.
One hundred and twenty-three eyes of 119 patients with a variety of vitreoretinal pathology underwent 23-gauge vitrectomy using the Alcon preloaded single step transconjunctival vitrectomy system and Accuris vitrectomy instrument between July 1, 2007 and November 30, 2007. Patients were observed post-operatively at day 1 and month 1.
Indications for surgery included nonclearing vitreous hemorrhage (n=41), epiretinal membrane (n=32), retinal detachment (n=27), macular hole (n=11), retained lens (n=7), silicone oil removal (n=2), endophthalmitis (n=2) and symptomatic floater (n=1). The mean preoperative IOP was 15.1 mmHg ±5.2 (range, 4 - 42 mmHg) and the mean postoperative day 1 IOP was 13.6 mmHg ±6.2 (range, 2 - 30 mmHg). Two eyes (1.6%) developed intraoperative choroidal effusions. Two eyes (1.6%) developed intraoperative horseshoe tears that were treated with cryopexy. No postoperative acute retinal detachments or endophthalmitis occurred. Two eyes (1.6%) had postoperative hypotony: one due to a wound leak that required a bandage contact lens and another due to ciliary body shutdown. Active wound leak following cannula removal requiring a sclerotomy suture at the end of vitrectomy occurred in 38% of patients: 34 eyes requiring 1 suture, 11 eyes requiring 2 sutures and 2 eyes required 3 sutures.
In this retrospective observational case series, the Alcon 23-gauge single step preloaded transconjunctival vitrectomy system demonstrates few significant safety issues. Sclerotomy leaks following cannula removal are common with 38% of eyes requiring at least one suture. Fewer than 1 % of eyes were hypotonous on post-op day one due to wound leaks.
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