Evaluation of Wound Closure in Oblique 23-gauge Sutureless Sclerotomies With Visante Optical Coherence Tomography

Taban, Mehran; Sharma, Sumit; Ventura, Alexandre A.C.M.; Kaiser, Peter K.

doi:10.1016/j.ajo.2008.07.046

Cited by 84 publications

(57 citation statements)

References 44 publications

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“…20 In addition, anterior segment OCT has demonstrated, in vivo, adequate wound apposition on the first post-operative day with oblique 23-gauge sclerostomy incisions. 21 It is noteworthy that, in keeping with our results, there are no published studies demonstrating an increased risk of endophthalmitis associated with the 23-gauge system.…”

Section: Discussionsupporting

confidence: 75%

Combined 23-gauge, sutureless transconjunctival vitrectomy with phacoemulsification without face down posturing for the repair of idiopathic macular holes

Heath

Rahman

2010

Eye

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Section: Discussionsupporting

confidence: 75%

Combined 23-gauge, sutureless transconjunctival vitrectomy with phacoemulsification without face down posturing for the repair of idiopathic macular holes

Heath

Rahman

2010

Eye

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“…At the first postoperative day, an IOP of <7 mm Hg was reported in 0–6.5% of the cases [3,7,8,9,16], and IOP rates of <10 mm Hg were reported in 2.6–10% of the cases (table 1), which is comparable to our rates (table 2). Mostly, hypotony resolves spontaneously [8,17], and postoperative suturing to prevent wound leakage is usually not required (table 1). …”

Section: Discussionmentioning

confidence: 99%

Subclinical Choroidal Detachment at Sclerotomy Sites after 23-Gauge Vitrectomy: Analysis by Anterior Segment Optical Coherence Tomography

Guthoff¹,

Riederle²,

Meinhardt³

et al. 2010

Ophthalmologica

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Purpose: Transient ocular hypotony commonly occurs after 23-gauge (23G) vitrectomy. To assess possible causes, we visualized the sclerotomy site and pars plana by anterior segment optical coherence tomography (AS-OCT). Procedures: We prospectively analyzed the intraocular pressure (IOP) and findings related to clinical hypotony, assessed by AS-OCT, in 13 consecutive eyes of 13 patients receiving 23G vitrectomy. Five patients receiving a 20G vitrectomy served as controls. Results: The mean IOP after 23G vitrectomy was 11 mm Hg (range: 5–32 mm Hg; 13 eyes) at postoperative day 1. In contrast to controls, AS-OCT showed a scleral gap at the incision site in 22/39 sclerotomies (10/13 eyes), and subclinical choroidal detachment in 9/13 eyes. Conclusions: A scleral gap and choroidal detachment at the incision site are frequent findings following 23G vitrectomy. These subclinical features may account for postoperative hypotony as they are absent in 20G vitrectomy and scleral sutures. Hypotony following 23G vitrectomy is a self-limiting phenomenon and usually does not require therapeutic intervention.

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“…Choroidal effusion is transitory, peripheral, and linked to hypotony; it resolves without any treatment. [17][18] The construction of the transconjunctival incision and of the sclerotomies (sufficiently oblique and long) is important to keep the sclerotomies self-sealed. The sclerotomy wounds seem closed on postoperative days 1 and 8, 18 but some contamination of the entire length of the incision by the ocular surface fluid could occur.…”

Section: Discussionmentioning

confidence: 99%

“…[17][18] The construction of the transconjunctival incision and of the sclerotomies (sufficiently oblique and long) is important to keep the sclerotomies self-sealed. The sclerotomy wounds seem closed on postoperative days 1 and 8, 18 but some contamination of the entire length of the incision by the ocular surface fluid could occur. 19 We observed no cases of endophthalmitis, but this complication has previously been described with a higher incidence for 25-gauge transconjunctival surgeries than the conventional 20-gauge sutured pars plana Eye vitrectomy.…”

Section: Discussionmentioning

confidence: 99%

23-Gauge transconjunctival sutureless pars plana vitrectomy: results of a prospective study

Schweitzer

Colin

et al. 2009

Eye

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Purpose To evaluate results of 23-gauge transconjunctival sutureless vitrectomy in various indications of vitreoretinal diseases. Design Prospective, non-comparative study. Materials and methods Fifty-seven consecutive eyes of 57 patients underwent vitreoretinal surgery by one surgeon using the 23-gauge, two-step instrumentation developed by Dutch Ophthalmic Research Center Inc., for epiretinal membranes (n ¼ 24), macular holes (n ¼ 10), diabetic retinopathy (n ¼ 4), rhegmatogenous retinal detachment (n ¼ 3), silicone oil removal (n ¼ 10), and other procedures (n ¼ 4). Mean operative time and intraoperative and postoperative complications were recorded. At 1 month, postoperative visual acuity, anatomical results, and induced astigmatism measured by Orbscan (BAUSCH and LOMB laboratories Inc., Rochester, NY, USA) were analysed. Results Mean operative time was 32.6±21.5 min. At 1 month, mean visual acuity improved from 1.09±0.82 to 0.80±0.79 logMar. Transient postoperative hypotony was the most common complication (21.1%), resolving without treatment. There was no choroidal effusion; and no postoperative endophthalmitis was observed. There were no significant changes in mean keratometry (P ¼ 0.957), mean axis (P ¼ 0.818), and power of astigmatism (P ¼ 0.860) at 1 month. Conclusions A 23-gauge vitrectomy seems to be safe and effective for a wide range of indications for vitreoretinal surgery. Further studies are needed to compare it with 25-gauge and 20-gauge vitrectomy in larger series.

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Evaluation of Wound Closure in Oblique 23-gauge Sutureless Sclerotomies With Visante Optical Coherence Tomography

Cited by 84 publications

References 44 publications

Combined 23-gauge, sutureless transconjunctival vitrectomy with phacoemulsification without face down posturing for the repair of idiopathic macular holes

Combined 23-gauge, sutureless transconjunctival vitrectomy with phacoemulsification without face down posturing for the repair of idiopathic macular holes

Subclinical Choroidal Detachment at Sclerotomy Sites after 23-Gauge Vitrectomy: Analysis by Anterior Segment Optical Coherence Tomography

23-Gauge transconjunctival sutureless pars plana vitrectomy: results of a prospective study

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