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O. Magalhaes, Jr., M. P. Avila, M. Maia, R. Nose, M. E. Farah, W. Nose; What's the Difference Between Bevel Facing Upward and Downward in 23-Gauge Incision? Anterior Chamber OCT and Intraocular Pressure Analysis. Invest. Ophthalmol. Vis. Sci. 2008;49(13):5957.
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To evaluate in human eyes submitted to pars-plana vitrectomy using 23-gauge one-step incision, (bevel-up X bevel-down) the following postoperative paramenters: incision extension, incision area, incision leakage and intraocular pressure.
The 23-gauge one step Alcon (Forth Worth, USA) trocar was used in 108 eyes. The eye stabilization was performed by Thorton ring and three angled incisions were performed. The patients were randomized in two groups: Group A- bevel facing upward (54 eyes) and Group B - bevel facing downward (54 eyes). One temporal incision was analyzed by the high-resolution mode of Anterior Chamber OCT- Visante (Carl Zeiss Meditec, Inc. (Dublin, USA)) for each eye. The measurement of incision extension and internal area were made by the software in the first postoperative day. Applanation Goldmann tonometer was also used for intraocular pressure measurement at the same timeline. Student T-test was performed to compare the results of both groups.
There was no difference between groups regarding the incision area average: 0,32 mm2 (group A) and 0,44 mm2 (group B) (p=0,68). The average of wounds extension were similar in both groups (2,05mm group A and 1,93 mm group B) (p=0,92). The percentages of incisions that required sutures at the end of the surgical procedures due to leakage were 3,2 % (group A) and 2,6% (group B). Average of postoperative intraocular pressure was also similar in both groups (A- 10,6 mmHg, and B- 11,3 mmHg) (p=0,85).
This study showed no difference of incision area, incision extension and intraocular pressure at the first postoperative day between both 23-gauge incisions tested (bevel facing upward X downward). The incisions leakage at the end of the surgical procedure were also very similar in both techniques.
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