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Transconjunctival Sutureless 23-gauge Vitrectomy for Vitreoretinal Diseases: Outcome of 30 Consecutive Cases.

El-Batarny AM - Middle East Afr J Ophthalmol (2008)

Bottom Line: Main outcome measures included surgical success, visual acuity, intraocular pressure, and operative complications.Subconjunctival silicone oil reported in one eye (3.3%).The safety profile compared favorably with published rates for 25-gauge systems.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Magrabi Eye and Ear Hospital, Muscat, Sultanate of Oman.

ABSTRACT

Background: To describe the initial experience, effectiveness, and safety profile of 23-gauge instrumentation for a variety of vitreoretinal conditions.

Methods: A retrospective review of 30 consecutive 23-gauge vitrectomy cases done by a single vitreoretinal surgeon for various posterior segment conditions was done. All surgeries were performed using the two-step 23-gauge system developed by Dutch Ophthalmic Research Center (DORC). All patients had at least 3-month follow-up. Main outcome measures included surgical success, visual acuity, intraocular pressure, and operative complications.

Results: Mean follow-up was 7.7 months (range 3-12 months). Indications for surgery included rhegmatogenous retinal detachment (n=8), nonclearing vitreous hemorrhage (n=6), tractional retinal detachment (n=5), macular hole (n=5), epiretinal membrane (n=3), retained lens fragments (n=2) and endophthalmitis (n=1). Gas tamponade was used in 18 eyes (60%) and silicone oil in six eyes (20%). Mean overall preoperative visual acuity was 20/1053 and final acuity was 20/78 (P = 0.001). Mean intraocular pressure after 6 hours was 15.1mmHg (range 4-25 mmHg) and on postoperative day one was 14.5 mmHg (range 2-21 mmHg). Four eyes (13.3%) required suturing of sclerotomy intraoperatively. Conversion to 20-gauge was done in one eye (3.3%). Hypotony was reported in one eye (3.3%) postoperatively. Subconjunctival silicone oil reported in one eye (3.3%). There were no postoperative complications of endophthalmitis, retinal or choroidal detachment.

Conclusion: 23-gauge transconjunctival sutureless vitrectomy was effective in the management of wide variety of vitreoretinal surgical indications. The safety profile compared favorably with published rates for 25-gauge systems.

No MeSH data available.


Related in: MedlinePlus

Illustration of the behavior of intraocular pressure (IOP) during the early postoperative period. In fluid filled eyes, IOP was lowermost among all groups, six hours and at day one after surgery. In gas filled eyes, IOP was highest among all groups' six hours and at day one after surgery. At one week, all groups approached the preoperative value.
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Figure 0002: Illustration of the behavior of intraocular pressure (IOP) during the early postoperative period. In fluid filled eyes, IOP was lowermost among all groups, six hours and at day one after surgery. In gas filled eyes, IOP was highest among all groups' six hours and at day one after surgery. At one week, all groups approached the preoperative value.

Mentions: In silicone filled eyes, no significant difference was found between the preoperative pressure and postoperative pressure at all measurement points (P at six hours = 0.09, P at day one=0.12 and P at one week= 0.06). Figure 2 describes the behavior of IOP in different subgroups in the early postoperative period. The mean intraocular pressure after surgery was lowest in cases where no tamponade was left in the eye compared to gas and silicone oil filled cases at six hours and on day one. Comparing the intraocular pressure means between fluid and gas filled eyes, the difference was significant at six hours (P=0.001), and on day one (P=0.001).but not after one week (P=0.088). After one week there was no significant difference between preoperative and postoperative IOP means in different subgroups.


Transconjunctival Sutureless 23-gauge Vitrectomy for Vitreoretinal Diseases: Outcome of 30 Consecutive Cases.

El-Batarny AM - Middle East Afr J Ophthalmol (2008)

Illustration of the behavior of intraocular pressure (IOP) during the early postoperative period. In fluid filled eyes, IOP was lowermost among all groups, six hours and at day one after surgery. In gas filled eyes, IOP was highest among all groups' six hours and at day one after surgery. At one week, all groups approached the preoperative value.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3040921&req=5

Figure 0002: Illustration of the behavior of intraocular pressure (IOP) during the early postoperative period. In fluid filled eyes, IOP was lowermost among all groups, six hours and at day one after surgery. In gas filled eyes, IOP was highest among all groups' six hours and at day one after surgery. At one week, all groups approached the preoperative value.
Mentions: In silicone filled eyes, no significant difference was found between the preoperative pressure and postoperative pressure at all measurement points (P at six hours = 0.09, P at day one=0.12 and P at one week= 0.06). Figure 2 describes the behavior of IOP in different subgroups in the early postoperative period. The mean intraocular pressure after surgery was lowest in cases where no tamponade was left in the eye compared to gas and silicone oil filled cases at six hours and on day one. Comparing the intraocular pressure means between fluid and gas filled eyes, the difference was significant at six hours (P=0.001), and on day one (P=0.001).but not after one week (P=0.088). After one week there was no significant difference between preoperative and postoperative IOP means in different subgroups.

Bottom Line: Main outcome measures included surgical success, visual acuity, intraocular pressure, and operative complications.Subconjunctival silicone oil reported in one eye (3.3%).The safety profile compared favorably with published rates for 25-gauge systems.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Magrabi Eye and Ear Hospital, Muscat, Sultanate of Oman.

ABSTRACT

Background: To describe the initial experience, effectiveness, and safety profile of 23-gauge instrumentation for a variety of vitreoretinal conditions.

Methods: A retrospective review of 30 consecutive 23-gauge vitrectomy cases done by a single vitreoretinal surgeon for various posterior segment conditions was done. All surgeries were performed using the two-step 23-gauge system developed by Dutch Ophthalmic Research Center (DORC). All patients had at least 3-month follow-up. Main outcome measures included surgical success, visual acuity, intraocular pressure, and operative complications.

Results: Mean follow-up was 7.7 months (range 3-12 months). Indications for surgery included rhegmatogenous retinal detachment (n=8), nonclearing vitreous hemorrhage (n=6), tractional retinal detachment (n=5), macular hole (n=5), epiretinal membrane (n=3), retained lens fragments (n=2) and endophthalmitis (n=1). Gas tamponade was used in 18 eyes (60%) and silicone oil in six eyes (20%). Mean overall preoperative visual acuity was 20/1053 and final acuity was 20/78 (P = 0.001). Mean intraocular pressure after 6 hours was 15.1mmHg (range 4-25 mmHg) and on postoperative day one was 14.5 mmHg (range 2-21 mmHg). Four eyes (13.3%) required suturing of sclerotomy intraoperatively. Conversion to 20-gauge was done in one eye (3.3%). Hypotony was reported in one eye (3.3%) postoperatively. Subconjunctival silicone oil reported in one eye (3.3%). There were no postoperative complications of endophthalmitis, retinal or choroidal detachment.

Conclusion: 23-gauge transconjunctival sutureless vitrectomy was effective in the management of wide variety of vitreoretinal surgical indications. The safety profile compared favorably with published rates for 25-gauge systems.

No MeSH data available.


Related in: MedlinePlus