Early Postoperative Hypotony After 25-Gauge Sutureless Vitrectomy With Straight Incisions

Acar, Nur; Kapran, Ziya; Ünver, Yaprak Banu; Altan, Tugrul; Ozdogan, Sezin

doi:10.1097/iae.0b013e318162b008

Cited by 73 publications

(43 citation statements)

References 19 publications

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“…27,28 This is important because postoperative hypotony is not uncommon after sutureless vitrectomy, which might allow bacterial entry into the vitreous through the sclerotomy sites. This could then lead to postoperative endophthalmitis.…”

Section: Discussionmentioning

confidence: 99%

Visual outcome and complications of 25-gauge vitrectomy for rhegmatogenous retinal detachment; 84 consecutive cases

Kunikata

Nishida

2010

Eye

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Purpose To assess the visual outcome and complications of 25-gauge transconjunctival sutureless vitrectomy (25G-TSV) for rhegmatogenous retinal detachments. Methods Retrospective, consecutive, interventional case series of 84 eyes of 84 consecutive patients with RRD who underwent 25G-TSV. All surgeries were performed by a single surgeon at a single centre. Results The initial and final reattachment rates were 95.2 and 100%, respectively. The mean visual acuity improved from 0.78 logarithm of the minimum angle of resolution (logMAR) units to 0.17 logMAR units at the final examination (Po0.001). A macula-off RRD was present preoperatively in 45 of the 84 eyes, and 11 of these eyes (24.4%) developed postoperative retinal complications. Of these complications, one eye had an intraoperative choroidal detachment, five developed a postoperative macular pucker, one eye had a postoperative macular hole, and four eyes developed a retinal redetachment. The percentages of eyes developing retinal complications in the macula-on group (2.6%) was significantly lower than that in the macula-off group (P ¼ 0.004). An intraocular pressure (IOP) X35 mm Hg was detected in five eyes (6.0%) within the first postoperative week. All of these eyes had a macula-off RRD, and none of the eyes with a macula-on RRD had an elevation of the IOP (P ¼ 0.04). Conclusions Our findings indicate that 25G-TSV is a feasible treatment for RRD and leads to retinal reattachment rates comparable with those following conventional vitrectomy. However, intra-and postoperative retinal complications and postoperative elevation of the IOP can occur especially in eyes with a preoperative macula-off RRD.

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Section: Discussionmentioning

confidence: 99%

Visual outcome and complications of 25-gauge vitrectomy for rhegmatogenous retinal detachment; 84 consecutive cases

Kunikata

Nishida

2010

Eye

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“…20 ). Similarly, Acar et al observed an incidence of hypotony under 8 mmHg in 17.1% of the eyes when straight sclerotomies were performed and intraocular tamponade was not used 21 . Bourgault, however, did not prove that oblique sclerotomies decreased the incidence of postoperative hypotony compared to straight sclerotomies both in eyes with gas tamponade or without tamponade (9.9% vs. 9.2%; P=0.85) (ref.…”

Section: Discussionmentioning

confidence: 84%

25-gauge vitrectomy and gas for the management of rhegmatogenous retinal detachment

Veith

Stranak

Pencak

et al. 2019

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

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Aims. To evaluate the anatomical and functional results in patients with rhegmatogenous retinal detachment (RRD) who underwent 25-gauge pars plana vitrectomy (PPV) with gas tamponade. Materials and Methods. A retrospective evaluation of 126 eyes of 126 patients (79 men, 47 women) with RRD who underwent 25-gauge PPV with gas tamponade (13% C3F8 in 87 eyes, 20% SF6 in 39 eyes). 113 patients (89.7%), were operated on under local anaesthesia, 13 patients (10.3%) under general anaesthesia. Macula was detached in 85 eyes (67.5%). 53 eyes had pseudophakic RRD, 73 eyes were phakic. Anatomical success of the primary intervention, change in best corrected visual acuity (BCVA) and incidence of complications were assessed. An average follow-up period is 7.2 months (6-15). Results. With single operation, retinal attachment was achieved in 125 eyes (99.2%); the final anatomical success was 100%. The initial mean BCVA was 0.89 logMar (2.00 to 0.00); at the end of the follow-up period, it improved to 0.23logMAR (1.00 to -0.10), P < 0,0001. During the first post-intervention day, hypotony of the eye below 10 mmHg was observed in 1 patient (0.8%); on the contrary, intraocular pressure was temporarily increased to 25 mmHg and more in 36 patients (28.6%). Conclusion. The surgical treatment of RRD using 25-gauge PPV with expansive gas tamponade renders excellent anatomical results and improvement in BCVA. The incidence of complications and necessity of sclerotomy suturing are low.

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“…In previous reports, the hypotony incidence after 25-gauge vitrectomy has been reported to be 0-30% at the first postoperative day 1 [4,6,7]. Early hypotony has also been reported to occur as early as postoperative hour 2 without any clinically prominent leakage by slitlamp examination [7].…”

Section: Discussionmentioning

confidence: 96%

“…The incidence of hypotony after 25-gauge vitrectomy has been described in several prospective and retrospective case series and was reported to be anywhere between 0% to 20% on post-operative day one [4,[6][7][8][9][10][11][12][13]. It has been noted to occur even in cases of 25-gauge vitrectomy that had sutures placed at the conclusion of surgery to close sclerotomies that appeared to persistently leak after cannula removal [7].…”

Section: Introductionmentioning

confidence: 99%

Sutured Versus Sutureless Sclerotomies after 25 Gauge Vitrectomy without an Internal Tamponade

Müftüoğlu¹,

Espina²,

Tsai³

et al. 2017

J Clin Exp Ophthalmol

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Objective: We wished to determine whether suturing of 25 gauge sclerotomies was advantageous in maintaining normal intraocular pressure (IOP) or preventing hypotony after 25-gauge vitrectomy in eyes not requiring internal tamponade.Methods: Two-hundred seventeen consecutive 25-gauge vitrectomy surgeries from 2010 to 2013 performed at a single center by two surgeons were retrospectively reviewed. Patients were divided into 2 groups based on the surgeon's routine use of suture in such cases. Surgeon 1 (sutureless group) did not suture any sclerotomies unless intra-operative leakage was noted and surgeon 2 (sutured group) sutured all 25 gauge sclerotomies routinely. Patient data was retrieved from charts and from this we determined the mean IOP change from baseline, hypotony incidence, and complications.Results: There was no significant difference in the mean IOP change at any postoperative visits (p=0.18 at postop day 1, p=0.3 at postop week 2, p=0.23 at postop 1 month, and p=0.43 at postop month 3) between the two groups. The hypotony rate was 10.9% in surgeon 1 and 9% in surgeon 2 group at postoperative day 1 (p=0.82). One patient required suture placement at postoperative day 1 in sutureless group. No complications were seen related with hypotony at any groups. Conclusion:In our population, there is no increased risk of hypotony with sutureless transconjunctival 25-gauge vitrectomy. Suturing of non-leaking 25-gauge wounds has no effect on complications from hypotony.

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Early Postoperative Hypotony After 25-Gauge Sutureless Vitrectomy With Straight Incisions

Abstract: Twenty-five-gauge sutureless vitrectomy with straight incisions resulted in a hypotony rate of 26.12% at 2 hours that decreased to 17.11% on day 1 and to 8.10% at week 1 but did not increase the incidence of postoperative complications.

Cited by 73 publications

References 19 publications

Visual outcome and complications of 25-gauge vitrectomy for rhegmatogenous retinal detachment; 84 consecutive cases

Visual outcome and complications of 25-gauge vitrectomy for rhegmatogenous retinal detachment; 84 consecutive cases

25-gauge vitrectomy and gas for the management of rhegmatogenous retinal detachment

Sutured Versus Sutureless Sclerotomies after 25 Gauge Vitrectomy without an Internal Tamponade

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