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L. T. Tran, C. M. Jermak, K. A. Bourgeois; Outcomes of Transconjunctival Sutureless 23-Gauge Vitrectomy. Invest. Ophthalmol. Vis. Sci. 2007;48(13):2211.
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To report the incidence of postoperative hypotony, intraoperative complications, and other postoperative complications with a Dutch Ophthalmic Research Center (DORC) 23-gauge transconjunctival vitrectomy system for the management of various vitreoretinal diseases.
This study is a retrospective review of 161 eyes of 151 consecutive patients who underwent 23-gauge transconjunctival sutureless vitrectomy by a single surgeon from April 2005 to August 2006. Indications for surgery included vitreous hemorrhage (n=65), epiretinal membrane (n=40), rhegmatogenous retinal detachment (n=16), idiopathic macular hole (n=13), retained lens fragment (n=12), endophthalmitis (n=5), uveitis (n=4), vitreous opacities (n=3), tractional retinal detachment associated with proliferative diabetic retinopathy (n =1 ), vitreous prolapse (n=1), and submacular hemorrhage (n=1). Main outcome measures included intraocular pressures, intraoperative complications, and postoperative complications.
The surgical goal of all cases was accomplished without intraoperative complications. Mean preoperative intraocular pressure was 16.9 mm Hg (range 4-59 mm Hg). On postoperative day 1, mean intraocular pressure was 15.9 mm Hg (range 4-48 mm Hg). There were 7 cases (4.35%) of hypotony (IOP < 6 mm Hg). Postoperative complications included 1 case of endophthalmitis (0.62%) and 1 case of retinal detachment (0.62%). There were no cases of choroidal detachment or suprachoroidal hemorrhage.
The incidence of hypotony (4.35%), endophthalmitis (0.62%), and retinal detachment (0.62%) in this study was comparable to previously reported rates of complication in 25-gauge transconjunctival vitrectomy. Similar to 25-gauge vitrectomy surgery, 23-gauge vitrectomy requires no scleral sutures and causes minimal conjunctival trauma. However, 23-gauge vitrectomy has an added advantage of larger and sturdier instrumentation. This study showed that 23-gauge transconjunctival sutureless vitrectomy is a safe and effective system for the management of various vitreoretinal diseases.
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