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J. S. Pollack; Initial Single Surgeon Experience Using a New Transconjunctival 23 Gauge Sutureless Vitrectomy System. Invest. Ophthalmol. Vis. Sci. 2007;48(13):2231.
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To assess the safety and efficacy of a new 23-gauge sutureless vitrectomy system using a single surgeon’s technique for one-step cannula insertion and removal.
A retrospective, single surgeon, interventional case series of 24 patients (25 surgeries) that underwent pars plana vitrectomy for various indications using a new 23-gauge sutureless vitrectomy system that utilizes a one-step style entry. One of two cannula insertion techniques was used in consecutive cases. Main outcome measures included intraocular pressure (IOP), number of sutured sclerotomies, intraoperative complications, and postoperative complications.
Median preoperative intraocular pressure was 15 mmHg (range, 6 - 28 mmHg) and the median intraocular pressure on the first postoperative day was 13 mmHg (range, 5-23 mmHg). Median intraocular pressure at 1 week was 14 mmHg (range, 9 - 37 mmHg). Median preoperative visual acuity was 20/125 (range, 20/30 to HM), and median postoperative visual acuity was 20/75 (range, 20/20-3/200) after a mean follow-up of 6.5 weeks (range, 1 day - 30 weeks). Sclerotomy sutures were required intraoperatively for 3% (2/75) of sclerotomies and postoperative day 1 hypotony was noted in 8% (2/25) of cases. Both of the sclerotomies that required sutures were created using an insertion technique that was abandoned after the first 10 cases. There were no cases of hypotony maculopathy and no postoperative intervention was required for hypotony. There were no intraoperative complications and cataract progression, noted in 20% (2/10) of phakic eyes, was the only postoperative complication.
Based on early post-op data analysis, the Alcon 23-gauge one-step entry sutureless vitrectomy system seems to be safe and effective for a variety of vitreoretinal procedures. Careful attention to cannula insertion technique is important for the prevention of prevention of sclerotomy leaks. Three to 10 month post-op follow-up available by March 2007, will be presented in an updated analysis.
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