May 2003
Volume 44, Issue 13
Free
ARVO Annual Meeting Abstract  |   May 2003
Evaluation of 25-gauge Transconjunctival Standard Vitrectomy (TSV) on Previously Non-operated Eyes
Author Affiliations & Notes
  • R.R. Lakhanpal
    Doheny Retina Institute, Doheny Eye Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
  • E. de Juan, Jr.
    Doheny Retina Institute, Doheny Eye Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
  • M.S. Humayun
    Doheny Retina Institute, Doheny Eye Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
  • J.I. Lim
    Doheny Retina Institute, Doheny Eye Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
  • T.S. Chang
    Doheny Retina Institute, Doheny Eye Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
  • L.P. Chong
    Doheny Retina Institute, Doheny Eye Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
  • G.Y. Fujii
    Doheny Retina Institute, Doheny Eye Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
  • A. Barnes
    Doheny Retina Institute, Doheny Eye Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
  • J.V. Rossi
    Doheny Retina Institute, Doheny Eye Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
  • Footnotes
    Commercial Relationships  R.R. Lakhanpal, None; E. de Juan, Jr., Bausch & Lomb F, C, P; M.S. Humayun, Bausch & Lomb C; J.I. Lim, None; T.S. Chang, None; L.P. Chong, None; G.Y. Fujii, None; A. Barnes, Bausch & Lomb F; J.V. Rossi, None.
  • Footnotes
    Support  Fletcher Jones Foundation
Investigative Ophthalmology & Visual Science May 2003, Vol.44, 2025. doi:
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      R.R. Lakhanpal, E. de Juan, Jr., M.S. Humayun, J.I. Lim, T.S. Chang, L.P. Chong, G.Y. Fujii, A. Barnes, J.V. Rossi; Evaluation of 25-gauge Transconjunctival Standard Vitrectomy (TSV) on Previously Non-operated Eyes . Invest. Ophthalmol. Vis. Sci. 2003;44(13):2025.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Abstract: : Purpose: To evaluate 25-gauge Transconjunctival Standard Vitrectomy (25-G TSV) for vitreoretinal procedures on non-operated eyes. Methods: Retrospective review of fifty-five eyes of fifty-five patients who underwent 25-G TSV by five surgeons (MSH, EdeJ, TSC, JIL, LPC) at the Doheny Retina Institute. Diagnoses included epiretinal membrane (19), tractional retinal detachment (10), non-clearing vitreous hemorrhage (6), branch retinal vein occlusion (8), rhegmatogenous retinal detachment (6), submacular pharmacological injection (4), and macular hole (2). Main outcome measures were pre- and postoperative visual acuity (VA), keratometry (K), intraocular pressure (IOP); intraoperative surgical time, infusion volume, sclerotomy closure, complications; conversion to 20-gauge (20-G) sclerotomy; postoperative inflammation, presence of bleb or choroidal detachment. Results: Twenty-six males and twenty-nine females with a median age of 58 (range, 29 to 75) were followed for a median of 21 weeks (range, 1 to 35). All underwent monitored, local anesthesia. Preoperative VA ranged from 20/50 to HM (median = 20/100) and postoperative VA ranged from 20/20 to 20/200 (median=20/40). Preoperative K was 84.5 +/- 4.5 D and postoperative K was 84.5 +/- 4.0 D. Mean preoperative IOP was 18 mmHg (range, 12 to 22) and mean postoperative IOP was 14 mmHg (range, 6-24). Mean total surgical time was 38 minutes (range, 7.25 to 81.25). Mean opening time was 2.5 minutes (range, 1.5 to 5.0); mean vitrectomy time was 33.5 minutes (range, 5.0 to 65.0); mean closing time was 2.5 minutes (range, 1.0 to 6.0). Median infusion volume was 100 milliliter (range, 50 to 225). Eight eyes (16.7%) required a sclerotomy suture. Three eyes (5.4%) required conversion to 20-G. Sixteen eyes (29%) presented on day one with blebs; two remained at day seven. All resolved by day thirty. Fifteen eyes had shallow choroidal detachments; six persisted at day seven. All resolved by day thirty. Four-fifths of eyes revealed zero inflammation by day thirty. Two patients developed postoperative retinal detachments that were successfully reattached. One patient developed culture-negative endophthalmitis successfully treated by 20-G vitrectomy and intravitreal antibiotics. Conclusions: 25-G TSV decreases inflammation, surgical time, anesthesia risks and causes minimal astigmatic corneal change, resulting in faster postoperative recovery. A multicenter, prospective study is warranted to further examine this new surgical option.

Keywords: vitreoretinal surgery • retina • retinal detachment 
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