Purpose To report a new approach for removal of Densiron-68 via pars plana with a 23-gauge transconjunctival sutureless vitrectomy system (TSVS). Methods Prospective, interventional case series. Ten eyes (4 phakic, 5 pseudophakic, 1 aphakic) of 10 patients underwent Densiron-68 (1480 mPa viscosity and 1.06 g/ml specific gravity) removal via pars plana with a suction pressure of 600-mmHg vacuum through a short 23-gauge silicon cannula. Results Densiron-68 was completely removed from all eyes. Retinal reattachment was achieved in all cases. The intraocular pressure was 20.9 (SD 3.5) mmHg at baseline, 12.2 (SD 4) mmHg at day 1 postoperatively, and 13.6 (SD 2.9), 15.4 (SD 2.5), and 16 (SD 1.8) mmHg after 1 week, 1 month, and 3 months, respectively. Five eyes needed suture of at least one sclerotomy. Postoperative hypotony (p8 mmHg) was seen in 2 out of 10 eyes (20%). No additional postoperative procedure was necessary. Conclusions Active removal of Densiron-68 with a 23-gauge short cannula is a simple, innovative, and safe technique that can help reduce surgical trauma.
Aims:To report a prospective non-comparative consecutive interventional study on the safety and efficacy of 23-Gauge transconjunctival sutureless pars plana vitrectomy for primary rhegmatogenous retinal detachment (RRD).Materials and Methods:Fifty eyes of 50 consecutive patients were recruited between June 2007 and January 2008. All surgeries were performed using the one-step 23-Gauge system with angled incisions. The surgical protocol consisted of a minimum of eight clinical visits: baseline, 1 day, 1 week, 1-, 3- and 6- months after the initial surgery. The endpoints were anatomical, functional results and complications arising from the surgery.Results:Anatomical success was achieved in 82% of cases (41 out of 50) with single surgery and rose to 98% (49 out of 50) with additional surgery. Mean visual acuity improved from logMAR 0.48(SD 0.36) to 0.26(SD 0.31), P < 0.001. Two cases with ocular hypotony, defined as an intraocular pressure ≤ 6mmHg, that were associated with a choroidal detachment were seen.Conclusions:Acceptable anatomical and functional success rates can be achieved with primary 23-Gauge transconjunctival sutureless vitrectomy for RRD. We found that the approach technique is different from conventional vitrectomy and the complications arising from post surgical hypotony and leakage from sclerotomies are potentially higher compared to 20-Gauge vitrectomy.
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