J Korean Ophthalmol Soc.  2010 Jun;51(6):835-841. 10.3341/jkos.2010.51.6.835.

Comparison of Intraocular Pressure Between Sutureless and Sutured 23-gauge Vitrectomy

• Kim HJ
• Hong S
• Park YS
• Sohn JH

• KMID: 2213618
• DOI: http://doi.org/10.3341/jkos.2010.51.6.835

Abstract

PURPOSE
To compare 23-gauge transconjunctival sutureless vitrectomy (TSV) and sutured vitrectomy in the aspect of intraocular pressure (IOP) changes and complications.
METHODS
Through a retrospective chart review, 45 sutureless patients (48 eyes) and 48 sutured patients (52 eyes) who had undergone 23-gauge transconjunctival vitrectomy by one surgeon (J.H. Sohn) were compared. IOP was measured routinely pre-operativley, at 1 day, 1 week, and 1 month post-operatively. Postoperative IOP, hypotony (IOP<7 mmHg) rates and complications associated with hypotony were assessed respectively. In addition, the cases involving intraocular air or gas tamponade or cataract extraction were compared.
RESULTS
One day after the surgery, 3 eyes of the sutureless group developed hypotony,which persisted in 2 eyes through postoperative 1 week. Two eyes of the sutureless group developed hypotony 1 week after the surgery. Most of the hypotony cases were transient, but choroidal detachment occurred in 2 cases, and retinal detachment occurred in 1 case. In contrast, none of the sutured group developed hypotony. Intraocular air or gas tamponade significantly raised IOP 1 day after the surgery. When the operation was combined with cataract extraction, IOP was reduced postoperative 1 week and 1 month.
CONCLUSIONS
The well-known risk factor of 23-gauge sutureless vitrectomy is postoperative hypotony. The present study showed postoperative hypotony can result in retinal detachment as a complication in contrast to previous studies. The authors conclude that suturing the wound for the prevention of hypotony is better, especially in cases with high risk of hypotony or definite wound leakage.

Keyword

Complication; Hypotony; Transconjunctival sutureless vitrectomy; 23-gauge

MeSH Terms

Cataract Extraction
Choroid
Eye
Humans
Intraocular Pressure
Retinal Detachment
Retrospective Studies
Risk Factors
Vitrectomy

Figure

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  Figure 1. Preoperative and postoperative IOP changes in 23-gauge vitrectomy. Post operative 1 day IOP is higher in sutured group than sutureless group (IOP: intraocular pressure, Op: operation, D: day, W: week, M: month).

Reference

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