Purchase this article with an account.
A.S. Noffke, R. Sarrafizadeh; Safety of Transconjunctival Sutureless 25–Gauge Vitrectomy in Eyes With Prior 20–Gauge Vitrectomy . Invest. Ophthalmol. Vis. Sci. 2005;46(13):5461.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Purpose: To determine the safety of transconjunctival sutureless 25–gauge vitrectomy (TSV25) in eyes that have previously had 20–gauge vitrectomy with or without scleral buckling surgery. Methods: Seventy–eight eyes (43 right) in 77 patients (35 female) who presented to our practice and subsequently had TSV25 were identified in a retrospective review. Follow–up ranged from 3–16 months (mean 8 months). Thirteen eyes had prior 20–gauge vitrectomy, 10 eyes had scleral buckling surgery, and 6 eyes had both. Sixteen eyes (21%) had TSV25 for vitreous hemorrhage or vitreous debris, 17 eyes (22%) for chronic diabetic macular edema, 34 eyes (43%) for macular pucker with cystoid macular edema, and 11 (14%) for macular hole. Final visual outcome, incidence of complications, and mean intraocular pressure on the first post–operative day and first post–operative week were measured as outcome variables. Results: Presenting mean visual acuity was 20/161 and final acuity was 20/72 for all eyes (P<0.0001, paired t–test). Mean intraocular pressure at post–operative day one was 11.5 in eyes with prior vitrectomy, and 12.4 in eyes without (P=0.45, pooled t–test). At post–operative week one, mean intraocular pressure was 13.7 in eyes with prior vitrectomy, and 16.9 in eyes without (P=0.14). Eyes with prior vitrectomy and scleral buckling surgery had a lower mean intraocular pressure at post–operative week one (10.8, P=0.05). In eyes with prior vitrectomy, one developed a prominent choroidal detachment that resolved completely in 2 weeks. Two eyes with no history of prior vitrectomy or scleral buckling surgery developed a macula–on retinal detachment. Conclusions: TSV25 appears to be safe in eyes with prior 20–gauge vitrectomy with or without scleral buckling surgery. Brief periods of relative hypotony during the post–operative period are well tolerated.
This PDF is available to Subscribers Only