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M. H. Soni, L. Tan, G. Murthy; Outcomes of 23 Gauge Transconjunctival Sutureless Vitrectomy Combined With Cataract Surgery and Primary Posterior Capsulotomy. Invest. Ophthalmol. Vis. Sci. 2008;49(13):5988.
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To report surgical outcomes of 23-gauge transconjunctival vitrectomy combined with cataract surgery, intraocular lens implant and primary posterior capsulotomy for the management of a variety of vitreoretinal diseases.
A retrospective, interventional case study was conducted. A review of a consecutive series of 36 eyes of 36 patients who underwent 23-gauge vitrectomy combined with phacoemulsification and intraocular lens implantation with primary posterior capsulotomy for epiretinal membrane (n = 12), idiopathic macular hole (n = 09), non-clearing vitreous haemorrhage (n = 10), rhegmatogenous retinal detachment (n = 05). Main outcome measures included pre and postoperative visual acuity, intraocular pressure, operating time, intra and postoperative complications.
The mean follow-up period was 8 months. The mean overall visual acuity improved from 6/36 pre-operatively to 6/12 post-operatvely at final visit. Fifteen cases required internal gas tamponade. Mean postoperative intraocular pressure on the first day was 14 mm of Hg. Operative time was shortened for vitreo-retina procedures considering the use of 23G transconjunctival sutureless vitrectomy. No intraoperative complications were noted attributable to small-gauge instruments and no cases required conversion to 20-gauge standard instrumentation. However, three patients required suture placement to one sclerotomy site. No case of endophthalmitis was observed throughout the follow-up period. None of the patients required further intervention.
23-gauge vitrectomy combined with cataract surgery and primary posterior capsulotomy is a safe and effective system for the management of a variety of vitreoretinal diseases. This technique exposes the patient only once to the surgery related complications and provides the best possible visual outcome with only one surgical intervention.
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