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S. G. Adams, Jr., M. Peden, R. Ratnakaram, S. Kaushal; Wound Closure in Sutureless 23 Gauge Pars Plana Vitrectomy: Ubm, Slit Lamp Photography, and Iop Results. Invest. Ophthalmol. Vis. Sci. 2008;49(13):5955.
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A recent change in pars plan vitrectomy (PPV) has been the advent of smaller gauge "sutureless" instrumentation. Sutureless systems are designed to create self-sealing and leak free sclerotomies. This study’s purpose was to evaluate sutureless 23 gauge (23G) wound integrity via ultrasonographic, photographic, and tonographic techniques using a retrospective case series analysis.
Subjects had 23G PPV by one of four surgeons at our institution. Perioperative assessment of wound leaks was judged by the surgeon, and sutures placed where indicated. UBM ultrasonography, slit lamp photography, and tonography was performed at post operative day (POD) one.
Well over half of 23G sclerotomies required sutured closure. In non-sutured sclerotomies, POD one slit lamp photographs demonstrate a dark area under the conjunctiva (Figure 1), giving the appearance of an open wound. UBM of the same site shows posterior wound closure (Figure 2). Neither post-operative hypotony nor other peri or post-operative complications were noted. The low complication rate is comparable to our experience with 25G PPV cases over the same time frame. However, no 25G cases required sutured closure.
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