Skip to main content

Advertisement

Log in

Intraocular pressure outcomes after 23-G vitreoretinal surgery with two different transconjunctival sutureless sclerotomy techniques: vertical versus tunnel entry

  • Original Paper
  • Published:
International Ophthalmology Aims and scope Submit manuscript

Abstract

Purpose

Comparison of postoperative intraocular pressure (IOP) course and early complications in 23-gauge (23-G) pars plana vitrectomy (PPV) using vertical entry sclerotomy and scleral tunnel sclerotomy in uncomplicated rhegmatogenous retinal detachment (RRD).

Method

A prospective, randomized, comparative, interventional clinical trial of 103 23-G vitrectomy cases using two different transconjunctival sutureless sclerotomy techniques performed by a single vitreoretinal surgeon for uncomplicated RRD. Fifty-two eyes underwent PPV using a three-port 23-G single stage, vertical trocar entry without creating a scleral tunnel (Group 1), while in 51 eyes, a two-stage, oblique trocar entry with creation of a scleral tunnel was performed (Group 2). Sulfur hexafluoride (SF6) gas (20%) was used in all cases as a buffer. Intraocular pressure measurements and detailed biomicroscopic examination of the groups were recorded on the postoperative first day, first week, and first month. Visual acuity and fundoscopic examinations were recorded at one month. The effects of the two methods on postoperative intraocular pressure and early complications were compared.

Results

There was no significant difference between the two groups in terms of age and gender (p > 0.05). The mean postoperative intraocular pressure on the first day was 15.06 ± 3.71 for Group 1 and 16.14 ± 3.09 mmHg for Group 2. The lowest recorded IOP was 6 mmHg. Postoperative visual acuity did not differ between the two groups (p > 0.05). In addition, IOP values did not differ statistically between the two groups (p > 0.05). In both groups, the mean IOP values measured at different intervals did not differ statistically (p > 0.05).

Conclusion

There was no significant difference in terms of postoperative IOP between vertical entry 23-G sclerotomy and 23-G tunnel entry sclerotomy for PPV with 20% SF6 tamponade surgery.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Mohamed S, Claes C, Tsang CW (2017) Review of small gauge vitrectomy: progress and innovations. J Ophthalmol 2017:6285869

    PubMed  PubMed Central  Google Scholar 

  2. Fujii GY, De Juan E Jr, Humayun MS, Chang TS, Pieramici DJ, Barnes A, et al (2002) Initial experience using the transconjunctival sutureless vitrectomy system for vitreoretinal surgery. Ophthalmology. 109 1814e20

  3. Fujii GY, De Juan E Jr, Humayun MS, Pieramici DJ, Chang TS, Awh C, et al (2002) A new 25-gauge instrument system for transconjunctival sutureless vitrectomy surgery. Ophthalmology 109 1807e12

  4. Eckardt CM (2005) Transconjunctival sutureless 23-gauge vitrectomy. Retina 25:208e11

    Article  Google Scholar 

  5. Oshima Y, Wakabayashi T, Sato T (2010) A 27-gauge instrument system for transconjunctival sutureless microincision vitrectomy surgery. Ophthalmology 117:93e102.e2

    Article  Google Scholar 

  6. Chen JC (1996) Sutureless pars plana vitrectomy through self-sealing sclerotomies. Arch Ophthalmol 114:1273e5

    Google Scholar 

  7. Lakhanpal RR, Humayun MS, de JuanJr E et al (2005) Outcomes of 140 consecutive cases of 25-gauge transconjunctival surgery for posterior segment disease. Ophthalmology 112:817–824

    Article  PubMed  Google Scholar 

  8. Byeon SH, Chu YK, Lee SC, Koh HJ, Kim SS, Know OW (2006) Problems associated with the 25-gauge transconjunctival sutureless vitrectomy system during and after surgery. Ophthalmologica 220:259–265

    Article  PubMed  Google Scholar 

  9. Thompson JT (2011) Advantages and limitations of small gauge vitrectomy. Surv Ophthalmol 56:162–172

    Article  PubMed  Google Scholar 

  10. Hsu J, Chen E, Gupta O et al (2008) Hypotony after 25-gauge vitrectomy using oblique versus direct cannula insertions in fluid-filled eyes. Retina 28:937–940

    Article  PubMed  Google Scholar 

  11. Woo SJ, Park KH, Hwang JM et al (2009) Risk factors associated with sclerotomy leakage and postoperative hypotony after 23-gauge transconjunctival sutureless vitrectomy. Retina 29:456–463

    Article  PubMed  Google Scholar 

  12. Lumi X, Lužnik Z, Petrovski G, Petrovski BE, Hawlina M (2016) Anatomical success rate of pars plana vitrectomy for treatment of complex rhegmatogenous retinal detachment. BMC Ophthalmol 16:216

    Article  PubMed  PubMed Central  Google Scholar 

  13. Hajari JN, Bjerrum SS, Christensen U, Kiilgaard JF, Bek T, la Cour M (2014) A nationwide study on the incidence of rhegmatogenous retinal detachment in Denmark, with emphasis on the risk of the fellow eye. Retina 34:1658–1665

    Article  PubMed  Google Scholar 

  14. Mitry D, Charteris DG, Fleck BW, Campbell H, Singh J (2010) The epidemiology of rhegmatogenous retinal detachment: geographical variation and clinical associations. Br J Ophthalmol 94:678–684

    Article  CAS  PubMed  Google Scholar 

  15. Schneider EW, Geraets RL, Johnson MW (2012) Pars plana vitrectomy without adjuvant procedures for repair of primary rhegmatogenous retinal detachment. Retina 32:213–219

    Article  PubMed  Google Scholar 

  16. Okamoto F, Yamane N, Okamoto C et al (2008) Changes in higherorder aberrations after scleral buckling surgery for rhegmatogenous retinal detachment. Ophthalmology 115:1216–1221

    Article  CAS  PubMed  Google Scholar 

  17. Machemer R, Aaberg TM, Freeman HM et al (1991) An updated classification of retinal detachment with proliferative vitreoretinopathy. Am J Ophthalmol 112:159–165

    Article  CAS  PubMed  Google Scholar 

  18. Ho JD, Liou SW, Tsai CY et al (2009) Trends and outcomes of treatment for primary rhegmatogenous retinal detachment: a 9- year nationwide population-based study. Eye (Lond) 23:669–675

    Article  Google Scholar 

  19. Jackson TL, Donachie PH, Sparrow JM SA, Johnston RL (2014) United Kingdom national ophthalmology database study of vitreoretinal surgery: report 3, retinal detachment. Ophthalmology 121:643–648

    Article  PubMed  Google Scholar 

  20. Zhou C, Qiu Q, Zheng Z (2015) Air versus gas tamponade in rhegmatogenous retinal detachment with inferior breaks after 23-gauge pars plana vitrectomy: a prospective, randomized comparative interventional study. Retina 35:886–891

    Article  PubMed  Google Scholar 

  21. Mancino R, Aiello F, Ciuffoletti E, Di Carlo E, Cerulli A, Nucci C (2015) Inferior retinotomy and silicone oil tamponade for recurrent inferior retinal detachment and grade PVR ineyes previously treated with pars plana vitrectomy or scleral buckle. BMC Ophthalmol 15:173

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  22. Caiado RR, Magalhães O Jr, Badaró E, Maia A, Novais EA, Stefanini FR et al (2015) Effect of lens status in the surgical success of 23-gauge primary vitrectomy for the management of rhegmatogenous retinal detachment: the Pan American Collaborative Retina Study (PACORES) group results. Retina 35:326–333

    Article  PubMed  Google Scholar 

  23. La Cour M, Lux A (2010) Heegaard S [Visual loss under silicone oil]. Klin Monatsbl Augenheilkd 227:181–184

    Article  PubMed  Google Scholar 

  24. Newsom RS, Johnston R, Sullivan PM, Aylward GB, Holder GE, Gregor ZJ (2004) Sudden visual loss after removal of silicone oil. Retina 24:871–877

    Article  PubMed  Google Scholar 

  25. Williams PD, Fuller CG, Scott IU, Fuller DG, Flynn HW (2008) Vision loss associated with the use and removal of intraocular silicone oil. Clin Ophthalmol 2:955–959

    PubMed  PubMed Central  Google Scholar 

  26. Shimada H, Nakashizuka H, Mori R, Mizutani Y (2005) Expanded indications for 25-gauge transconjunctival vitrectomy. Jpn J Ophthalmol 49:397–401

    Article  PubMed  Google Scholar 

  27. Gupta OP, Weichel ED, Regillo CD et al (2007) Postoperative complications associated with 25-gauge pars plana vitrectomy. Ophthalmic Surg Lasers Imaging 38:270–275

    Article  PubMed  Google Scholar 

  28. Gupta OP, Ho AC, Kaiser PK et al (2008) Short-term outcomes of 23-gauge pars plana vitrectomy. Am J Ophthalmol 146:193–197

    Article  PubMed  Google Scholar 

  29. Naruse Z, Shimada H, Mori R (2019) Surgical outcomes of 27-gauge and 25-gauge vitrectomy day surgery for proliferative diabetic retinopathy. Int Ophthalmol 39:1973–1980

    Article  PubMed  Google Scholar 

  30. Mitry D, Chalmers J, Anderson K, Williams L, Fleck BW, Wright A et al (2011) Temporal trends in retinal detachment incidence in Scotland between 1987 and 2006. Br J Ophthalmol 95:365–369

    Article  PubMed  Google Scholar 

  31. Hilford D, Hilford M, Mathew A, Polkinghorne PJ (2009) Posterior vitreous detachment following cataract surgery. Eye (Lond) 23:1388–1392

    Article  CAS  Google Scholar 

  32. Teke MY, Balikoglu-Yilmaz M, Yuksekkaya P, Citirik M, Elgin U, Kose T et al (2014) Surgical outcomes and incidence of retinal redetachment in cases with complicated retinal detachment after silicone oil removal: univariate and multiple risk factors analysis. Retina 34:1926–1938

    Article  PubMed  Google Scholar 

  33. Stangos AN, Petropoulos IK, Brozou CG, Kapetanios AD, Whatham A, Pournaras CJ (2004) Pars-plana vitrectomy alone vs vitrectomy with scleral buckling for primary rhegmatogenous pseudophakic retinal detachment. Am J Ophthalmol 138:952–958

    Article  PubMed  Google Scholar 

  34. Taylor SR, Aylward GW (2005) Endophthalmitis following 25-gauge vitrectomy. Eye 19:1228–1229

    Article  CAS  PubMed  Google Scholar 

  35. Liu DT, Chan CK, Fan DS, Lam SW, Lam DS, Chan WM (2005) Choroidal folds after 25-gauge transconjunctival sutureless vitrectomy. Eye 19:825–827

    Article  CAS  PubMed  Google Scholar 

  36. Ibarra MS, Hermel M, Prenner JL, Hassan TS (2005) Longer-term outcomes of transconjunctival sutureless 25- gauge vitrectomy. Am J Ophthalmol 139:831–836

    Article  PubMed  Google Scholar 

  37. Inoue M, Shinoda K, Shinoda H, Kawamura R, Kawamura R, Suzuki K, Ishida S (2007) Two-step oblique incision during 25-gauge vitrectomy reduces incidence of postoperative hypotony. Clin Experiment Ophthalmol 35:693–6

    Article  PubMed  Google Scholar 

  38. Rizzo S, Genovesi-Ebert F (2007) Angled incision techniques for 25-G and 23-G surgery. Euretina, Montecarlo

  39. Pollack J (2007) Microincision vitrectomy surgery transitional course. American Academy of Ophthalmology meeting, 8 November, New Orleans

  40. Hsu J, Chen E, Gupta O (2008) Hypotony after 25-gauge vitrectomy using oblique versus direct cannula insertions in fluid-filled eyes. Retina 28:937e40

    Article  Google Scholar 

  41. Yamane S, Kadonosono K, Inoue M, Kobayashi S, Watanabe Y, Arakawa A (2011) Effect of intravitreal gas tamponade for sutureless vitrectomy wounds: three-dimensional corneal and anterior segment optical coherence tomography study. Retina 31:702–706

    Article  PubMed  Google Scholar 

  42. O’Reilly P, Beatty S (2007) Transconjunctival sutureless vitrectomy: initial experience and surgical tips. Eye 21:518–521

    Article  Google Scholar 

  43. Fine HF, Iranmanesh R, Iturralde D, Spaide RF (2007) Outcomes of 77 consecutive cases of 23-gauge transconjunctival vitrectomy surgery for posterior segment disease. Ophthalmology 114:1197–1200

    Article  PubMed  Google Scholar 

  44. Schweitzer C, Delyfer M-N, Colin J, Korobelnik J-F (2009) 23-Gauge transconjunctival sutureless pars plana vitrectomy: results of a prospective study. Eye 23:2206–2214

    Article  CAS  PubMed  Google Scholar 

  45. Hassani RTJ, Sanharawi ME, Adam R, Monin C, Dupont-Monod S, Baudouin C (2013) Influence of sutureless 23-gauge sclerotomy architecture on postoperative intraocular pressure decrease: results of a multivariate analysis. Graefes Arch Clin Exp Ophthalmol 251:1285–1292

    Article  Google Scholar 

Download references

Funding

The authors have no financial interests to report.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Sevim Ayca Seyyar.

Ethics declarations

Conflict of interest

The authors have no conflict of interest to report.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Seyyar, S.A., Saygılı, O. & Tıskaoğlu, N.S. Intraocular pressure outcomes after 23-G vitreoretinal surgery with two different transconjunctival sutureless sclerotomy techniques: vertical versus tunnel entry. Int Ophthalmol 42, 1763–1769 (2022). https://doi.org/10.1007/s10792-021-02172-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10792-021-02172-7

Keywords

Navigation