23-Gauge transconjunctival sutureless pars plana vitrectomy: results of a prospective study

Abstract

Purpose To evaluate results of 23-gauge transconjunctival sutureless vitrectomy in various indications of vitreoretinal diseases. Design Prospective, non-comparative study. Materials and methods Fifty-seven consecutive eyes of 57 patients underwent vitreoretinal surgery by one surgeon using the 23-gauge, two-step instrumentation developed by Dutch Ophthalmic Research Center Inc., for epiretinal membranes (n ¼ 24), macular holes (n ¼ 10), diabetic retinopathy (n ¼ 4), rhegmatogenous retinal detachment (n ¼ 3), silicone oil removal (n ¼ 10), and other procedures (n ¼ 4). Mean operative time and intraoperative and postoperative complications were recorded. At 1 month, postoperative visual acuity, anatomical results, and induced astigmatism measured by Orbscan (BAUSCH and LOMB laboratories Inc., Rochester, NY, USA) were analysed. Results Mean operative time was 32.6±21.5 min. At 1 month, mean visual acuity improved from 1.09±0.82 to 0.80±0.79 logMar. Transient postoperative hypotony was the most common complication (21.1%), resolving without treatment. There was no choroidal effusion; and no postoperative endophthalmitis was observed. There were no significant changes in mean keratometry (P ¼ 0.957), mean axis (P ¼ 0.818), and power of astigmatism (P ¼ 0.860) at 1 month. Conclusions A 23-gauge vitrectomy seems to be safe and effective for a wide range of indications for vitreoretinal surgery. Further studies are needed to compare it with 25-gauge and 20-gauge vitrectomy in larger series.

Early surgical results of a 23-gauge trocar combined with a one-directional valve system in primary and secondary pars plana vitrectomy

“…All of them resolved spontaneously in 1 week, which was also the most common complication in our series. Schweitzer et al observed postoperative hypotony in 21.1% of their cases; postoperative hypotony was the most common complication in their series also (10). Postoperative hypotony was observed in 6.5% of cases in Gupta et al 's series and 3.4% in Chieh et al 's series (3,5).…”

Safety of 20-Gauge Transconjunctival Sutureless Vitrectomy

“…In 23-gauge transconjunctival sutureless vitrectomy, the incidence of postoperative hypotony varies between 2.6 and 22.8% [27,39,52,53,54,55,56]. In the 25-gauge one, this incidence has a mean of 13% between articles [7,57,58,59].…”

Refractive change after vitrectomy for epiretinal membrane in pseudophakic eyes

“…The use of small sutureless incisions has greatly reduced the surgically induced astigmatism, and this is no longer a matter of concern in small gauge vitrectomy (Kadonosono et al 2006;Schweitzer et al 2009). We did not observe a significant surgically induced astigmatism in our study.…”