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

Eye (Lond). 2009 Dec;23(12):2206-14. doi: 10.1038/eye.2008.431.

Abstract

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=24), macular holes (n=10), diabetic retinopathy (n=4), rhegmatogenous retinal detachment (n=3), silicone oil removal (n=10), and other procedures (n=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=0.957), mean axis (P=0.818), and power of astigmatism (P=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.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Conjunctiva / surgery*
  • Eye Diseases / surgery
  • Female
  • Humans
  • Intraoperative Complications
  • Male
  • Middle Aged
  • Postoperative Complications
  • Prospective Studies
  • Suture Techniques*
  • Visual Acuity
  • Vitrectomy / instrumentation
  • Vitrectomy / methods*
  • Young Adult