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Jiro Kogo, Akira shiono, Hitoshi Takagi; Swept-source OCT images of sclerotomy site of 27-gauge vitrectomy. Invest. Ophthalmol. Vis. Sci. 2016;57(12):4463.
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© ARVO (1962-2015); The Authors (2016-present)
Recently, 27-gauge vitrectomy system was commercially available. Previously, we have demonstrated the detail and the time course change of prototype 27-gauge sclerectomy site by optical coherence tomography (OCT) (Eye in press). To assess the relationship among the wound closure, ciliochoroidal detachment (CD) and intraocular pressure (IOP) after 27-gauge microincision vitrectomy surgery (MIVS).
Twenty six eyes of 26 patients with several vitreoretinal disease that underwent 3-port 27-gauge vitrectomy (Alcon) were prospectively studied. The intraocular pressure (IOP) was measured before surgery, and at 1, 2, 4 and 14 days postoperatively. All of the 78 sclerotomies were examined by swept source OCT (SS-OCT) to assess the wound and the presence of a ciliochoroidal detachment (CD) at 1, 2, 4 and 14 days postoperatively. A closure of the sclerotomy site was defined as an absence of a scleral gap in the SS-OCT images. The mean IOP and closure rate of the sclerotomies were compared between eyes with and without a ciliochoroidal detachment. The correlation between the presence of ciliochoroidal detachment and postoperative IOP was determined.
The rates of sclerotomy non-closure at 1, 2, 4, and 14 days were 69.2% (54/78), 65.2% (51/78), 46.2% (36/78) and 9.0% (7/78). The incidence of CD was 46.2% (12 eyes) at 1day, 34.6% (9 eyes) and 11.5% (3 eyes). No eyes with CD were observed at 14 days postoperatively. The mean postoperative IOPs were significantly lower than baseline in eyes with a CD (P < 0.05). The incidence of open sclerotomies was significantly higher in eyes with a CD than in eyes without a CD at 1 and 2 days postoperatively (P <0.01).
A shallow CD develops in 46.2% of eyes at 1 day and 34.6% of eyes at 2 days after 27-gauge MIVS. Lower IOP at the early postoperative period may be a risk factor for a CD.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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