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B. Keyser, D. B. Roth, A. Hira, J. L. Prenner; Complications Associated With 280 Consecutive Cases of 25-Gauge Transconjunctival Vitrectomy. Invest. Ophthalmol. Vis. Sci. 2007;48(13):2250.
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To report the complications associated with eyes undergoing 25-gauge transconjunctival vitrectomy.
A retrospective, consecutive chart review of 271 patients (280 eyes) having undergone 25-gauge transconjunctival vitrectomy was performed. All surgery was performed by one of eight vitreoretinal surgeons in a university affiliated group practice. Main outcome measures were hypotony (< 7 mm Hg), elevated intraocular pressure (> 25 mm Hg), post-operative complications, and need for additional surgeries or treatments post-operatively.
Mean pre-operative intraocular pressure (IOP) was 17.0 + 4.6 mm Hg. Mean IOP on post-operative day #1 and post-operative days #2-10 were 15.4 + 6.9 mm Hg and 17.8 + 7.2 mm Hg, respectively. Post-operative complications were hypotony in 9 eyes (3.2%), elevated IOP in 37 eyes (13.2 %), retinal detachment in 6 eyes (2.1%), worsening cataract in 63 eyes (22.5%), vitreous hemorrhage in 11 eyes (3.9%), choroidal detachment in 2 eyes (0.7%), post-operative inflammation in 5 eyes (1.8%), retinal tear in 5 eyes (1.8%), anterior chamber fibrin in 1 eye (0.4%), and pupillary membrane in 1 eye (0.4%). 27 eyes underwent a second surgery where the median number of days between the first and second surgery was 68.5 days (range 3-365 days). Mean follow up was 6.9 + 3.9 months (range 1.0-17.8).
25-gauge sutureless transconjunctival vitrectomy has allowed for a less invasive approach to vitreoretinal surgical procedures. The technique appears to be safe with a low incidence of serious complications. Complications were similar to those seen with 20-gauge vitrectomy except that there was a higher incidence of post-operative hyptony after 25-gauge vitrectomy. There were no cases of endophthalmitis in this series of 25-gauge vitrectomy surgeries.
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