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Han, Cho, Lee, Kim, and Lee: The Clinical Results of Sutureless Vitrectomy Using 23-Gauge Surgical System
Original Article

J Korean Ophthalmol Soc 2008;49(6):911-916.

Published online: 8 September 2008

DOI: https://doi.org/10.3341/jkos.2008.49.6.911

The Clinical Results of Sutureless Vitrectomy Using 23-Gauge Surgical System

Jung Il Han, M.D.1, Sung Won Cho, M.D., Ph.D.1, , Tae Gon Lee, M.D.2, Jong Woo Kim, M.D., Ph.D.2, Jae Heung Lee, M.D., Ph.D.1

1Myung-Gok Eye Research Institute, Konyang University Kim’s Eye Hospital Seoul, Korea

2Department of Ophthalmology, College of Medicine, Konyang University Deajeon, Korea

Address reprint requests to Sung Won Cho, M.D., Ph.D. Kim’s Eye Hospital #156 Youngdeungpo-dong 4ga, Youngdeungpo-gu, Seoul 150-034, Korea Tel: 82-2-2639-7777, Fax: 82-2-2677-9214, E-mail: eyecure@kimeye.com

5 February 2008       Accepted 31 January 2007

Copyright © 2015 Korean Ophthalmological Society

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

The purpose of this study is to evaluate the clinical results of 23-gauge sutureless vitrectomy.

Methods

We retrospectively analyzed 111 eyes that had undergone 23-gauge sutureless vitrectomy. The eyes underwent surgery from February 2006 to July 2006 and were examined for surgical outcome as well as intraoperative and postoperative complications.

Results

The preoperative best corrected visual acuity (BCVA) was 1.43±0.12 and increased to 0.88±0.11 ( P>0.01). Thirteen (11.7%) of 111 eyes developed intraoperative complications, and 21 (18.9%) of 111 eyes developed postoperative complications. Intraoperative complications included wound‐ leaking (seven eyes), conjunctival suture (three eyes), and difficult insertion (two eyes). Postoperative complications included postoperative hypotony (seven eyes), vitreous hemorrhage (seven eyes), hyphema (five eyes), and infectious endophthalmitis (two eyes).

Conclusions

Unlike 20-gauge vitrectomy, sutureless 23-gauge vitrectomy offers all the advantages of minimally invasive sutureless vitrectomy.

Keywords: 23 gauge system, Sutureless vitrectomy

References

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Figure 1.
Photographs taken at postoperative day 1 showing mild conjunctival injection especially at the cannula insertion area.
jkos-49-911f1.tif
Figure 2.
Photographs show movable conjunctiva and no scar tissue after conjunctival dissection in case of reoperation for silicone oil removal.
jkos-49-911f2.tif
Table 1.
Preoperative diagnosis
Preoperative diagnosis No. of eyes (%)
PDR* 44 (39.6)
Epiretinal membrane 19 (17.1)
Macular hole 18 (16.2)
Vitreous hemorrhage due to RVO† 16 (14.4)
Rhegmatogenous retinal detachment 4 (3.6)
PDR with RVO 3 (2.7)
Vitreous hemorrhage due to ARMD 2 (1.8)
VMT‡ syndrome 2 (1.8)
Lens material dislocation to vitreous 1 (0.9)
Vitreous opacity due to uveitis 1 (0.9)
Secondary glaucoma due to IVTA§
 1 (0.9)
Total 111 (100)

* PDR = proliferative diabetic retinopathy

† RVO = retinal vein occlusion

‡ VMT = vitreomacular traction

§ IVTA = intravitrea triamcinolone injection.

Table 2.
Combined procedure with 23-gauge sutureless vitrectomy
Combined procedure No. of eyes (%)
Air fluid exchange 44 (39.6)
Phacoemulsification 7 (6.3)
Silicone oil injection
 2 (1.8)
Total 53 (47.7)
Table 3.
Mean intraocular pressure change
Intraocular pressure change
Preoperative 12.76±3.19 mmHg
Postoperative 1 day 12.50±6.11 mmHg*
Postoperative 15 day 13.36±5.28 mmHg*

* Paired standard t-test P-value>0.05.

Table 4.
Complications
Complications No. of eyes (%)
Scleral suture due to leaking 8 (7.2)
Conjunctival suture 3 (2.7)
Difficulty insertion 2 (1.8)
Postoperative hypotony* 7 (6.3)
Vitreous hemorrhage 7 (6.3)
Hyphema 5 (4.5)
Endophthalmitis
 2 (1.8)
Total 34 (30.6)

* Hypotony = intraocular pressure < 5 mmHg.

Table 5.
Leaking cases
Leaking cases Operative procedures Location
ERM V MP P2*
ERM V MP EL P3†
PDR, TRD V MP EL FGE P2
PDR V MP EL FGE SOI P2
PDR, TRD V MP EL FGE SOI P2
PDR, VH V MP EL FGE P3
PDR V MP EL P3
PDR, TRD V MP IVTA P3

ERM = epiretinal membrane; PDR = proliferative diabetic retinopathy; TRD = tractional retinal detachment; VH = vitreous hemorrhage; V = vitrectomy; MP = membrane peeling; EL = endolaser; FGE = fluid gas exchange; SOI = silicone oil injection; IVTA = intravitreal triamcinolone injection.

* P2 = port for instrument

† P3 = port for endoilluminator.

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