Minimal Fluid–air Exchange in Combined 23-Gauge Sutureless Vitrectomy, Phacoemulsification, and Intraocular Lens Implantation

Abstract

Minimal fluid-air exchange in combined 23-gauge sutureless vitrectomy and cataract surgery may reduce postoperative hypotony and intraocular lens-related complications.

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

“…24,42,43,[48][49][50][51] Postoperative hypotony at any point within the first week in this series after 25-gauge PPV was seen in 5 of 54 patients (9.3%), which is consistent with the published rates of hypotony after 25-gauge PPV that range from 0% to 9.2%. 21,52,53 The overall rate of hypotony at any point in the first postoperative week in our series regardless of size of instrumentation was 9.8% (9 of 92 patients).…”

Efficacy of combined 25-gauge microincision vitrectomy, intraocular lens implantation, and posterior capsulotomy

“…2,11 Posterior capsule opacification is also reported to occur more frequently after phacovitrectomy (12.5%) than after phacoemulsification and IOL implantation alone (4.6%). 12 Our study also supports existing data showing that posterior capsulotomy is a practical method for preventing postoperative PCO in patients with vitreoretinal disease who require a phacovitrectomy.…”

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.…”