Abstract
Purpose::
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.
Methods::
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.
Results::
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.
Conclusions::
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.
Keywords: vitreoretinal surgery • retina • vitreous