Self-Sealing Sclerotomies for Sutureless Pars Plana Vitrectomy

Abstract

* OBJECTIVE: To determine the efficacy of self-sealing pars plana sclerotomies for vitrectomy and to identify complications associated with this new technique. * METHOD: There were 150 self-sealing sclerotomies performed in 50 patients undergoing pars plana vitrectomy between October 1996 and March 1998. * RESULTS: Of the 150 sclerotomies, 115 (76.6%) did not require suturing while 35 (23.3%) were closed with one radial 7.0 vicryl suture. The scleral tunnel incisions ensured minimal loss of intraocular fluids during instrument exchange and scleral plugs were not required to avoid ocular hypotony during scleral indentation. Distortion of scleral flap incisions requiring a suture were commonly seen in procedures using multiple instrumentations and extensive explants. * CONCLUSIONS: Sutureless sclerotomies are simple to perform, save operative time, and reduce the risk of peroperative hypotony following removal of instruments or the infusion cannula. The technique reduces postoperative inflammation, suture-related problems including astigmatism, and allows more rapid rehabilitation. [Ophthalmic Surg Lasers 2000;31:462-466]

Surgical Outcomes of 27-Gauge Vitrectomy for a Consecutive Series of 163 Eyes With Various Vitreous Diseases

“…Minimally invasive vitreoretinal surgery has been proposed in the past by other authors. 5 – 8 , 10 , 25 Chen 1 proposed a sutureless tunnel-based sclerotomy, but the case series reported in that study revealed difficulty in the passage of conventional instruments along with several complications, including wound extension, dehiscence, and leakage, vitreous and/or retinal incarceration, hemorrhage, retinal tears, and dialysis. 1 , 5 , 8 As a result of the weakness and reduced efficiency of the 27-G instruments, some studies have reported the necessity of converting to a larger-gauge system.…”

Fluid dynamics in three 25‐gauge vitrectomy systems: principles for use in vitreoretinal surgery

“…Sutureless 25-gauge pars plana vitrectomy has the potential to reduce the length of surgery and postoperative inflammation at the sclerotomy sites, thus decreasing patient discomfort postoperatively and hastening recovery (Chen 1996;Kwok et al 1999;Jackson 2000;Lam et al 2000;Rahman et al 2000;Fujii et al 2002a).…”

25-Gauge Transconjunctival Sutureless Pars Plana Vitrectomy

“…This method aimed to avoid suture-related complications, and to shorten the operation time. However, related to the technique, surgical difficulties and several complications such as wound leakage, dehiscence and hemorrhage, retinal break, vitreous and/or retinal incarceration, and dialyses have been reported (4,5). Furthermore, the scleral tunnel technique requires conjunctival dissection and subsequent suturing (5,6).…”