Surgically induced astigmatism in combined phacoemulsification and vitrectomy; 23-gauge transconjunctival sutureless vitrectomy versus 20-gauge standard vitrectomy

Park, Dong Ho; Shin, Jae Pil; Kim, Si Yeol

doi:10.1007/s00417-009-1109-3

Cited by 49 publications

(35 citation statements)

References 25 publications

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“…Several studies reported the safety and effectiveness of the 23-gauge MIVS. [7][8][9][10][11] However, there have been questions regarding the self-sealing characteristics and postoperative hypotony in some of the cases. 8,12,13 Previously localized conjunctival and episcleral pigmentation after 20-gauge conventional vitrectomy has been considered owing to a reaction to the sutures used to close the sclerotomy site.…”

Section: Introductionmentioning

confidence: 99%

Conjunctival pigmentation after 23-gauge microincisional vitrectomy surgery

Park

Shin

Kim

2011

Eye

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Aim To investigate cases with conjunctival pigmentation originating from sclerotomy sites after 23-gauge microincisional vitrectomy surgery (MIVS). Methods This is a retrospective study comprised of 185 eyes from 185 consecutive patients who underwent 23-gauge MIVS. The authors investigated the incidence and the clinical factors associated with conjunctival pigmentation, including indication of vitrectomy and surgical procedures. Results Eight eyes (4.3%) from 185 eyes showed conjunctival pigmentation after surgery within 7 days postoperatively. Light microscopic examination of excised tissue showed infiltration of abundant dark brownish colored melanophages with surrounding scattered, finely granular, melanin pigments. C3F8 gas tamponade (OR, 9.4; 95% CI, 1.9-44.5; P ¼ 0.005) was significantly associated with conjunctival pigmentation. The mean surface area (21.26 ± 2.21 mm 2 ) of three eyes with C3F8 tamponade was significantly larger than that of five eyes (2.51 ± 0.73 mm 2 ) without tamponade (P ¼ 0.025). Neither leakage nor hypotony was found. Conclusions Intraocular melanin pigments could prolapse through the sclerotomy site and cause conjunctival pigmentation after 23-gauge MIVS. Thus, preoperative warning is necessary in patients with 23-gauge MIVS.

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Section: Introductionmentioning

confidence: 99%

Conjunctival pigmentation after 23-gauge microincisional vitrectomy surgery

Park

Shin

Kim

2011

Eye

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“…In the toric IOL group, the IOL cylinder power and alignment axis were calculated using a web-based toric IOL calculator program (available at: http://www.acrysoftoriccalculator.com) taking into account the keratometry readings and mandatory data input on the position of the incision and the SIA by superior incision (0.30 D), which was measured from our previous investigation. 7 The manufacturer's information shows the SN60T3, SN60T4, and …”

Section: Patients and Study Designmentioning

confidence: 99%

“…[4][5][6] Recently, 23-gauge microincisional vitrectomy surgery (MIVS) had less surgically induced astigmatism (SIA) compared with 20-gauge vitrectomy. 7 However, it could not correct pre-existing corneal astigmatism.…”

Section: Introductionmentioning

confidence: 99%

Combined 23-gauge microincisonal vitrectomy surgery and phacoemulsification with AcrySof toric intraocular lens implantation: a comparative study

Park

Shin

Kim

2011

Eye

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Aim To compare AcrySof toric intraocular lens (IOL) and non-toric IOL in patients who had combined 23-gauge microincisional vitrectomy surgery (MIVS) and phacoemulsification for vitreoretinal diseases and cataract with pre-existing corneal astigmatism. Methods This is a prospective comparative study comprised of 30 patients (30 eyes) who had combined 23-gauge MIVS and phacoemulsification for vitreoretinal diseases and cataract with pre-existing regular corneal astigmatism greater than 1 diopters (D). In all, 15 eyes had AcrySof toric IOL (Alcon Laboratories) and 15 eyes had non-toric IOL (Akreos AO MI60; Bausch & Lomb) implantation. Main outcome measures were uncorrected visual acuity (UCVA), refractive cylinder, surgically induced astigmatism (SIA), and IOL misalignment during 6 months. Results The mean UCVA of the toric IOL group was better than the non-toric IOL group at postoperative months 1, 3, and 6 (Po0.001, respectively). The mean absolute residual refractive cylinder of the toric IOL group at postoperative week 1, and months 1, 3, and 6 was less than the non-toric IOL group (P ¼ 0.008, o0.001, o0.001, and o0.001, respectively). There was no difference in the mean SIA between the two groups (P40.05, respectively). The mean toric IOL axis rotation was 3.52±2.751, which was within 51 in 66.7% of the toric IOL group and within 101 in 100%.Conclusions Combined 23-gauge MIVS and phacoemulsification with AcrySof toric IOL implantation is an effective method of correcting vitreoretinal diseases and cataract and pre-existing corneal astigmatism, and the toric IOL showed good rotational stability, even in vitrectomized eyes for 6 months.

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“…The advantages of sutureless small-gauge vitrectomy include techni cal simplicity, less traumatic conjunctival and scleral manipulation, shorter operative durations, less severe postoperative pain, and faster postoperative visual recovery (2,3) . Several studies have demonstrated corneal changes induced by standard 20-G vitrectomy; however, few studies have investigated (2)(3)(4)(5) . This study aimed to evaluate and compare corneal topographic changes following pars plana vitrectomy (PPV) using 20-, 23-, and 25-G systems.…”

Section: Introductionmentioning

confidence: 99%

A comparison study of corneal topographic changes following 20-, 23-, and 25-G pars plana vitrectomy

Grandinetti¹,

Kniggendorf²,

Moreira³

et al. 2015

Arquivos Brasileiros De Oftalmologia

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Purpose: To evaluate and compare corneal topographic changes following pars plana vitrectomy with the 23-gauge (G) and 25-G transconjuntival sutureless vitrectomy system as well as the standard 20-G vitrectomy system. Methods: We prospectively evaluated corneal topographic changes in 45 eyes of 45 patients divided into three groups according to vitrectomy system used (20-, 23-, and 25-G). All patients underwent computer-assisted videokeratography using an EyeSys System 3000 topographer preoperatively and at one week, one month, and three months postoperatively. Results: In the 20-G vitrectomy group, we found statistically significant postoperative changes in corneal curvature parameters with an average steepening of 0.98 ± 0.18 D (P<0.001) and 0.93 ± 0.21 D (P<0.001) at one week and one month, respectively. No statistically significant difference was observed at the three-month follow-up visit. In the 23-and 25-G groups, no statistically significant changes in corneal curvature parameters were observed at any postoperative follow-up visit. Conclusion: Twenty-three-gauge and 25-gauge transconjunctival sutureless vitrectomy did not induce topographic corneal changes following surgery, whereas 20-G vitrectomy was found to induce transient topographic corneal changes that had returned to preoperative levels at three months postoperatively.

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Surgically induced astigmatism in combined phacoemulsification and vitrectomy; 23-gauge transconjunctival sutureless vitrectomy versus 20-gauge standard vitrectomy

Abstract: Combined phacoemulsification and pars plana vitrectomy (23-gauge and 20-gauge) could induce significant SIA at postoperative week 1, and decrease over 3 months. However, 23-gauge TSV showed less SIA and early stabilization compared to the 20-gauge standard vitrectomy.

Cited by 49 publications

References 25 publications

Conjunctival pigmentation after 23-gauge microincisional vitrectomy surgery

Conjunctival pigmentation after 23-gauge microincisional vitrectomy surgery

Combined 23-gauge microincisonal vitrectomy surgery and phacoemulsification with AcrySof toric intraocular lens implantation: a comparative study

A comparison study of corneal topographic changes following 20-, 23-, and 25-G pars plana vitrectomy

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