J Korean Ophthalmol Soc.  2008 Jun;49(6):911-916. 10.3341/jkos.2008.49.6.911.

The Clinical Results of Sutureless Vitrectomy Using 23-Gauge Surgical System

• Han JI
• Cho SW
• Lee TG
• Kim JW
• Lee JH

• KMID: 2110871
• DOI: http://doi.org/10.3341/jkos.2008.49.6.911

Abstract

PURPOSE: The purpose of this study is to evaluate the clinical results of 23-gauge sutureless vitrectomy.
METHODS
We retrospectively analyzed 111 eyes that had undergone 23-gauge sutureless vitrectomy. The eyes underwent surgery from February 2006 to July 2006 and were examined for surgical outcome as well as intraoperative and postoperative complications.
RESULTS
The preoperative best corrected visual acuity (BCVA) was 1.43+/-0.12 and increased to 0.88+/-0.11 (P>0.01). Thirteen (11.7%) of 111 eyes developed intraoperative complications, and 21 (18.9%) of 111 eyes developed postoperative complications. Intraoperative complications included wound.leaking (seven eyes), conjunctival suture (three eyes), and difficult insertion (two eyes). Postoperative complications included postoperative hypotony (seven eyes), vitreous hemorrhage (seven eyes), hyphema (five eyes), and infectious endophthalmitis (two eyes).
CONCLUSIONS
Unlike 20-gauge vitrectomy, sutureless 23-gauge vitrectomy offers all the advantages of minimally invasive sutureless vitrectomy.

Keyword

23 gauge system; Sutureless vitrectomy

MeSH Terms

Endophthalmitis
Eye
Hyphema
Intraoperative Complications
Postoperative Complications
Retrospective Studies
Sutures
Visual Acuity
Vitrectomy
Vitreous Hemorrhage

Figure

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  Figure 1. Photographs taken at postoperative day 1 showing mild conjunctival injection especially at the cannula insertion area.

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  Figure 2. Photographs show movable conjunctiva and no scar tissue after conjunctival dissection in case of reoperation for silicone oil removal.

Reference

References

1. Machemer R, Buettner H, Norton EW, Parel JM. Vitrectomy: a pars plana approach. Trans Am Acad Ophthalmol Otolaryngol. 1971; 75:813–20.

2. O’Malley, Heintz RM Sr. Vitrectomy with alternative instrument system. Ann Ophthalmol. 1975; 7:585-8–591-4.

3. Chen JC. Sutureless pars plana Vitrectomy through self-sealing sclerotomies. Arch Ophthalmol. 1996; 114:1273–5.

4. Juan E Jr, Hickingbotham D.Refinements in microinstrumentation for vitreous surgery. Am J Ophthalmol. 1990; 109:218–220.

5. Fujii GY, Juan E Jr, Humayun MA. . A new 23-guage instrument system for transconjunctival sutureless vitrectomy surgery. Ophthalmology. 2002; 109:1814–20.

6. Eckardt C. Transconjunctival sutureless 23-gauge Vitrectomy. Retina. 2005; 25:208–11.

7. James FW, Zdenek JG. Fibrovascular ingrowth and recurrent haemorrhage following diabetic vitrectomy. Br J Ophthalmol. 2000; 84:822–5.

8. Eifrig CW, Scott IU, Flynn HW Jr. . Endophthalmitis after pars plana vitrectomy: Incidence, causative organisms, and visual acuity outcomes. Am J Ophthalmol. 2004; 138:799–802.

9. Stephen JR. Retina. 4th ed. Vol. 3. Baltimore: Mosby;2006; 2645–54.

10. Rai P. Lauande-Pimentel R, Barton K. Amniotic membrane as an adjunct to donor sclera in the repair of exposed glaucoma drainage devices. Am J Ophthalmol. 2005; 140:1148–52.