Visual outcomes and complications of transconjunctival sutureless 23-gauge vitrectomy.

Abstract

Purpose : To compare visual outcomes and complications in eyes undergoing vitrectomy using 23-gauge and 20-gauge vitrectomy system.

Design : retrospective,comparative,case series.

Methods : Chart review of initial 30 consecutive patients that underwent transconjunctival sutureless 23-gauge vitrectomy (from October 2008 to August 2009) and 40 consecutive patients that underwent conventional 20-gauge vitrectomy (from May 2006 to September 2008) by one surgeon were performed. The inclusion criteria for this study included eyes that underwent vitrectomy for various indications including nonclearing vitreous hemorrhage (29 eyes), retained lens fragment and lens dislocation (16 eyes), tractional retinal detachment associated with proliferative diabetic retinopathy (9 eyes), macular hole (4 eyes), endophthalmitis (6 eyes), rhegmatogenous retinal
detachment (4 eyes), and other (2 cases), and postoperative follow-up of at least 3 months. Main outcome measures included best-corrected Snellen visual acuity (VA), intraoperative complications and postoperative

Results : Vision improved from logMAR 2.16 to logMAR 0.82(P<0.001), from logMAR 2.30 preoperatively to logMAR 1.14 (P<0.001) with 20 and 23-gauge systems,respectively. All group showed statistically significant improvement in visual acuity(P=<0.05).In 20-gauge group, retinal break occurred in one eyes(2.5%). Postoperative complications included rebleeding in one eyes(2.5%), cataract in three eye(7.5%). In 23-gauge group, wound leak occurred in two eyes( 6.6%). Postoperative complications included hypotony in three eyes(10.0%), rebleeding in one eye(3.3%), cataract in three eyes (10.0%). No cases of retinal tear or endophthalmitis were observed.

Conclusions : The conventional 20-gauge and transconjunctival sutureless 23-gauge vitrectomy system for pars plana vitrectomy offers significantly improved in visual acuity. Intraoperative wound leak and postoperative hypotony were the most common complications observed in 23-gauge group. However, the visual acuity and complications did not differ significantly between both groups.

Keys word : vitrectomy, 23 gauge,20 gauge, complications, visual acuity