Comparison of 23‐gauge sutureless sclerotomy architecture and clinical outcomes in macular and non‐macular surgery using spectral‐domain optical coherence tomography

Abstract

In 23-G PPV, non-macular surgery is associated with a significant postoperative IOP decrease in comparison with macular surgery, which could be explained by the most remodelled wound architecture.

Influence of orientation of the external linear incision created by the 25-gauge trocar and related factors on sclerotomy closure: A clinical and optical coherence tomographic study

“…Increased surgical manipulation and repeated passage of instruments through superior sclerotomies have been related to increased suturing at these sclerotomies when compared to the relatively static infusion port. [ 2 18 ] In our study, the proportion of sutured sclerotomies in SNQ and INQ was significantly less than self-sealed sclerotomies, whereas the proportion of self-sealed and sutured sclerotomies was not statistically different in STQ. When analyzing the port sites in relation to the right-handed surgeon, we found that left-sided ports and infusion ports had proportionally lesser suturing, whereas the right-sided ports were sutured more often.…”

“…On the other hand, analysis of the influence of surgery duration on sclerotomy closure has shown conflicting results. [ 2 3 16 18 ] In our cohort, when comparing the time taken for surgeries that required suturing and those that did not, we found no significant difference. This could be explained by the wide surgical indications for patients in both groups of this study.…”

“…2 ]. [ 2 ] Wound healing in 25G sclerotomies, as graded by the AS-OCT, is seen to be complete by 2 weeks to 1 month after surgery. [ 25 ] Among the gradable sclerotomies in our study, irrespective of the quadrant analyzed, the odds of having an open sclerotomy tract was found to be more than 5 in patients who had circumferential sclerotomies and a statistically significant difference was found in SNQ.…”

“…Research has shown that centrifugal forces directed outward from within the eye are important for the closure of a beveled incision on the eye wall. [ 2 ] In beveled incisions, the internal lip presses against the outer lip aided by the IOP, thereby helping the closure of the wound and reducing the risk of leakage, hypotony, and infection. [ 3 4 ] This affixing of the inner and outer lip increases as the IOP increases.…”

“…Nevertheless, the use of sutures is often required to avoid wound leak and hypotony in the postoperative period. [ 2 ] Vertical entry into the eye was replaced by the use of oblique incisions to promote self-sealing. [ 3 4 ] Multiple methods of sclerotomy creation have been described to take advantage of scleral stromal thickness.…”