Abstract
Abstract: :
Purpose: We studied the complications of 25 gauge pars plana vitrectomy based on the surgical indications in various vitreoretinal disorders. Materials and Method: Twenty patients underwent pars plana vitrectomy with the 25 gauge sutureless vitrectomy technique. Indications were: proliferative diabetic retinopathy (PDR) with vitreous hemorrhage (5), PDR with tractional retinal detachment (4), distracting vitreous floaters (5), dislocated intraocular lens implant (2), silicone oil removal (2), macular pucker (1), and pseudophakic cystoid macular edema (1). Results: Intraoperative and postoperative complications included: postoperative hypotony (in one case of PDR with tractional retinal detachment) which resolved spontaneously, the need to suture the sclerotomy (in both of the oil removal cases), the need to switch to 20 gauge vitrectomy (in one case of PDR with tractional retinal detachment). All cases in which complications were noted had undergone previous vitrectomy. No cases of serious postoperative complications such as retinal detachment, persisting hypotony, or endophthalmitis, were seen. Conclusion: Although 25 gauge vitrectomy is applicable for a wide range of indications, case selection is a significant factor in reducing the incidence of complications. Previously vitrectomized eyes have a higher incidence of complications related to postoperative leakage, possibly due to the lack of plugging effect of peripheral vitreous on the unsutured sclerotomy. One should consider suturing any leaking sclerotomy in previously vitrectomized eyes at the conclusion of the surgery.
Keywords: vitreoretinal surgery • clinical (human) or epidemiologic studies: outcomes/complications • vitreous