Study of Intraocular Pressure After 23-Gauge and 25-Gauge Pars Plana Vitrectomy Randomized to Fluid Versus Air Fill

Abstract

When performing 23-gauge or 25-gauge pars plana vitrectomy, there was no difference in mean IOP for fluid- versus air-filled eyes. However, the mean IOP in the immediate postoperative period was statistically lower, and there was a higher rate of suture closure for 23-gauge compared with 25-gauge instrumentation.

Comparison of Clinical Features After 20-Gauge Vitrectomy Versus 23-Gauge Vitrectomy

“…Whether hypotony was associated with the tamponade is still controversial. 18,19 In our cases, eyes filled with fluid had a much higher incidence of hypotony than those filled with gas or silicone oil. In our opinion, gas or silicone oil can provide a tamponade effect on the wound internally, which can help the wound close more effectively.…”

Diathermy of Leaking Sclerotomies After 23-Gauge Transconjunctival Pars Plana Vitrectomy

“…This could be related to subclinical loss of air or gas, as previously reported. 12 After 23-gauge TSV, the reported incidence of hypotony is 6.5% to 11.3% in the early postoperative period, 12,25 and 0% to 10% at 1 day, [12][13][14][19][20][21][22]24,25,28,[35][36][37][38] with a resolution within 1 week. We found hypotony in 4.5% of the treated eyes at 6 hours, in 1.5% at day 1, and in no eye at 3 days; the only factor associated with the occurrence of hypotony at 6 hours was the age younger than 50 years.…”

“…[6][7][8][9][10][11][12][13][19][20][21][22] Risk factors for a leaking sclerotomy during 23-gauge TSV are myopia, thin sclera, history of previous vitrectomy, a young age at operation, vitreous base dissection, the use of intravitreal triamcinolone, multiple exchanges of instruments, pseudophakia, combined phacoemulsification and vitrectomy procedures, and absence of tamponade. 3,[12][13][14][15]23 The incidence of leaking sclerotomy requiring intraoperative suture placement in 23-gauge TSV ranges between 0% and 38.0% 6,12,19,20,22,[24][25][26][27][28] ; this variability is probably related to different inclusion criteria, such as surgical indications, vitreous base dissection, tamponading agents, and reoperations.…”

Surgical Complications of Primary Rhegmatogenous Retinal Detachment: A Meta-Analysis

“…Choroidal detachment may occur as a result of hypotony in scleral buckling, the risk factors include trauma, particularly the surgical trauma of choroidal perforation, systemic hypertension, glaucoma and high myopia[23,26]. Some surgical procedures such as scleral buckling and puncture used during SB procedure are no longer existed in vitrectomy; moreover, small-gauge transconjunctival instrumentation used in vitrectomy has been reported to reduce surgical complications[27]. …”