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M. H. Soni, D. McHugh; 23 Gauge Transconjunctival Sutureless Vitrectomy System - Study of 115 Eyes. Invest. Ophthalmol. Vis. Sci. 2007;48(13):2227.
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The aim of the study was to assess the efficacy and safety of 23 Gauge Trans conjunctival Sutureless Vitrectomy (TSV) system for complex vitreo-retinal surgical procedures.
We performed various vitreo-retinal surgical procedures for 115 eyes using 23 G TSV. The main indications for the surgery were retinal detachment with PVR, delamination for diabetic retinopathy, macular hole, epiretinal membrane, vitreous haemorrhage and dropped nucleus.Sixty-seven patients received gas tamponade at the end of the operation. There was no need of suture to close the conjunctival or scleral opening site.The patients were examined daily for the first two days after the procedures and at four weeks interval thereafter. The average follow-up was ten weeks.
The surgical procedures using the 23 G TSV are almost similar to the standard 20 G vitrectomy system. We could accomplish the surgical goal in all cases. The mean post-op intraocular pressure on first post-operative day was 16 mm of Hg. We found minimal subconjunctival haemorrhage in 12% of cases. No complications resulted from the opening site.The light source, infusion flow rate, cutting rate and rigidity of instruments are quite comparable with standard 20 G vitrectomy system. The 23 G TSV does not have any limitations for any complex vitreo-retinal cases except for injectiong 5000 cs silicone oil and intraocular foreign body cases where the sclerotomy site may need to be enlarged. The minimal flexibility of the instruments had no negative intra operative effects.
The 23 Gauge Trans conjunctival Sutureless Vitrectomy system (TSV) has all advantages of the minimally invasive trans conjunctival vitrectomy system; it requires no scleral sutures, causes minimal or no conjunctival trauma. The 23 G TCV is as effective and safe as 20 G standard vitrectomy system for complec vitreo-retinal cases but has significantly reduced surgical and rehabilitation time.
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