Ultrasound Biomicroscopy Findings of Sclerotomy Sites in Oblique Versus Direct Cannula Insertion Technique in 25-Gauge Transconjuctival Sutureless Vitrectomy

Abstract

Purpose:: To report the ultrasound biomicroscopy (UBM) findings at the sclerotomy sites on postoperative day one after 25-gauge transconjunctival sutureless vitrectomy (TSV) comparing an oblique insertion technique to the conventional direct insertion technique.

Methods:: Two patients underwent 25-gauge TSV using an oblique cannula insertion technique, and one patient underwent 25-gauge TSV using the standard direct cannula insertion technique. All three patients had UBM imaging of the sclerotomy sites performed on postoperative day one.

Results:: No complications from the oblique cannula insertion technique were seen. UBM findings following the oblique insertion technique revealed no wound gape in one patient and minimal wound gape with mild vitreous incarceration in the second patient. UBM findings following the conventional insertion technique demonstrated more significant wound gape at all three sclerotomy sites.

Conclusions:: Compared to the standard direct cannula technique, creating a shelved incision with the oblique cannula insertion technique may help achieve better sclerotomy wound closure. In theory, improved wound closure may decrease rates of hypotony and endophthalmitis following 25 gauge TSV.

Keywords: vitreoretinal surgery • wound healing • sclera