Outcomes of 140 Consecutive Cases of 25-Gauge Transconjunctival Surgery for Posterior Segment Disease

Lakhanpal, Rohit R.; Humayun, Mark S.; Juan, Eugene de; Lim, Jennifer I.; Chong, Lawrence P.; Chang, Tom; Javaheri, Michael; Fujii, Gildo Y.; Barnes, A.; Alexandrou, Terry J.

doi:10.1016/j.ophtha.2004.11.053

Cited by 335 publications

(219 citation statements)

References 18 publications

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“…Furthermore, the instruments are too flexible and a complete peripheral vitrectomy or complex manoeuvres are less easy to manage than with the 23-gauge vitrectomy, limiting the indications to isolated vitreous haemorrhage, epiretinal membrane peeling, macular hole, and some uncomplicated retinal detachment. 1,[30][31][32][33] The 23-gauge transconjunctival system has the advantages of the 25-gauge vitrectomy with an expansion of the range of indications to complex retinal detachment, diabetic retinopathy, and other vitreoretinal tractions requiring a complete peripheral vitrectomy with scleral depression, as was described in a previous study. 3,15 The rate of vacuum and the level of cut of the vitrector can be adapted to a 23-gauge system as well as the conventional 20-gauge system.…”

Section: Discussionmentioning

confidence: 99%

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

Schweitzer

Colin

et al. 2009

Eye

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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.

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Section: Discussionmentioning

confidence: 99%

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

Schweitzer

Colin

et al. 2009

Eye

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“…6,5,12 However, direct comparison with 20-gauge vitrectomy has not been described in the literature. The mean operating time for all the 50 cases in each group was 39.4 (20 gauge) vs 29 min (23 gauge) Po0.001.…”

Section: Eyementioning

confidence: 99%

“…5 Eliminating suturing may also shorten total operating time. 6 The Oertli 23-gauge vitrectomy system has been in use in this unit for 18 months.…”

Section: Introductionmentioning

confidence: 99%

23-gauge sutureless vitrectomy and 20-gauge vitrectomy: a case series comparison

Misra

Ho-Yen

Burton

2008

Eye

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Purpose To directly compare the per-operative safety and efficacy of the 20-and 23-gauge vitrectomy systems as well as day 1 intraocular pressure (IOP). Methods Data were collected on 50 consecutive vitrectomy cases performed using the 20-gauge system and 23-gauge sutureless vitrectomy. All surgeries were carried out by one surgeon (RLB) at a single centre. Data collected prospectively included indication for surgery, iatrogenic retinal tears, and operating times. Results Most common indications for surgery were macular hole, rhegmatogenous retinal detachment, diabetic vitreous haemorrhage (no tractional retinal detachment), and macular pucker. Intraocular tamponade with air, sulphur hexafluoride (SF6), hexafluoroethane (C2F6) or octafluoropropane (C3F8), or silicone oil was used in 25 patients in the 20-gauge group and 46 patients in the 23-gauge group. One scleral port required suture in patients who underwent 23-gauge vitrectomy (0.67%). Every 20-gauge patient had all the three ports sutured. The mean first day IOP was 22.88 mm Hg in the 20-gauge vs 17.58 mm Hg in the 23-gauge (Po0.001). Four patients in the 20-gauge group had an IOP 440 mm Hg compared to none in the 23-gauge group. In contrast, four patients had postoperative hypotony in the 23-gauge group compared to none in the 20-gauge group. The mean operating time for all the 50 cases in each group was 39.4 (20 gauge) vs 29 min (23 gauge) Po0.001. Conclusion Our study indicates less risk of considerably raised IOPs and reduced surgical operating time with the 23-gauge system. Additional advantages observed included faster wound healing, diminished conjunctival scarring, improved patient comfort, and decreased postoperative inflammation.

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“…Postoperative-wound leak and hypotony have been reported with 25-and 23-gauge transconjunctival vitrectomy systems [1][2][3][4][5] and may be associated with the removal of peripheral vitreous gel. 1 No patient in our series developed hypotony or subconjunctival bleb formation after surgery.…”

Section: Commentmentioning

confidence: 99%

“…The advantages of 23-gauge sutureless transconjunctival vitrectomy compared to conventional 20-gauge vitrectomy are shorter surgical [1][2][3] and recovery time, 1,4 and less postoperative discomfort. 1 We reviewed the outcome of 23-gauge transconjunctival vitrectomy in patients with postoperative endophthalmitis.…”

Section: Introductionmentioning

confidence: 99%

Outcome of 23-gauge sutureless transconjunctival vitrectomy for endophthalmitis

Tan

Wong

Yang

et al. 2007

Eye

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Purpose To review the outcomes of 23-gauge transconjunctival vitrectomy in patients with postoperative endophthalmitis. Methods Non-randomized, interventional case series of patients with postoperative endophthalmitis over a 1-year period.Results 23-gauge transconjunctival vitrectomy was performed on 6 patients with a mean age of 67.7 years without intraoperative or postoperative complications. There were no cases of postoperative hypotony or wound leak. The mean change in IOP was À4.2 mmHg compared to the preoperative IOP (P ¼ 0.239). Final VA improved significantly compared to preoperative VA (P ¼ 0.062), with VA of at least 20/40 in 5 of 6 patients (83.3%). Conclusions 23-gauge transconjunctival vitrectomy is a useful technique for treating postoperative endophthalmitis.

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Outcomes of 140 Consecutive Cases of 25-Gauge Transconjunctival Surgery for Posterior Segment Disease

Cited by 335 publications

References 18 publications

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

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

23-gauge sutureless vitrectomy and 20-gauge vitrectomy: a case series comparison

Outcome of 23-gauge sutureless transconjunctival vitrectomy for endophthalmitis

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