Skip to main content

Advertisement

SpringerLink
Log in

Outcomes of transconjunctival sutureless 27-gauge vitrectomy with silicone oil infusion

  • Retinal Disorders
  • Published:
Graefe's Archive for Clinical and Experimental Ophthalmology Aims and scope Submit manuscript

Abstract

Purpose

To demonstrate the safety and efficacy of 27-gauge pars plana vitrectomy (PPV) in selected patients with vitreoretinal diseases requiring silicone oil (SO) tamponade.

Methods

Retrospective review of a consecutive interventional case series at a single center.

Results

Twenty-one eyes of 19 patients were included in the study. The indications for PPV and SO tamponade were as follows: fibrovascular tractional retinal detachment (12 eyes), rhegmatogenous retinal detachment with proliferative vitreoretinopathy (three eyes), primary rhegmatogenous retinal detachment (two eyes), macular hole (two eyes), vitreous hemorrhage (one eye), and endophthalmitis (one eye). All eyes underwent transconjunctival sutureless 27-gauge PPV with either 1000-cS (16 eyes) or 5000-cS (five eyes) SO tamponade. No intraoperative complications occurred. Mean preoperative best-corrected visual acuity (BCVA) was 20/300 (range, light perception to 20/40; median, counting fingers). Mean postoperative BCVA was 20/160 (range, no light perception to 20/25; median 20/300; p = 0.022). Follow-up was 6.4 ± 8.8 months (range, 1–38 months; median, 4 months). No complications relating to 27-gauge placement of SO were observed.

Conclusions

Results show that 27-gauge PPV with SO injection appears safe, is efficient, and may be considered for the surgical management of vitreoretinal diseases requiring SO tamponade.

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

Access this article

Log in via an institution

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

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Fujii GY, De Juan E Jr, Humayun MS, Pieramici DJ, Chang TS, Awh C, Ng E, Barnes A, Wu SL, Sommerville DN (2002) A new 25-gauge instrument system for transconjunctival sutureless vitrectomy surgery. Ophthalmology 109:1807–1812

    Article  PubMed  Google Scholar 

  2. Fujii GY, De Juan E Jr, Humayun MS, Chang TS, Pieramici DJ, Barnes A, Kent D (2002) Initial experience using the transconjunctival sutureless vitrectomy system for vitreoretinal surgery. Ophthalmology 109:1814–1820

    Article  PubMed  Google Scholar 

  3. Lakhanpal RR, Humayun MS, de Juan E, Lim JI, Chong LP, Chang TS, Javaheri M, Fujii GY, Barnes AC, Alexandrou TJ (2005) Outcomes of 140 consecutive cases of 25-gauge transconjunctival surgery for posterior segment disease. Ophthalmology 112:817–824

    Article  PubMed  Google Scholar 

  4. Eckardt C (2005) Transconjunctival sutureless 23-gauge vitrectomy. Retina 25:208–211

    Article  PubMed  Google Scholar 

  5. Kadonosono K, Yamakawa T, Uchio E, Yanagi Y, Tamaki Y, Araie M (2006) Comparison of visual function after epiretinal membrane removal by 20-gauge and 25-gauge vitrectomy. Am J Ophthalmol 142:513–515

    Article  PubMed  Google Scholar 

  6. Rizzo S, Genovesi-Evert F, Murri S, Belting C, Vento A, Cresti F, Manca ML (2006) 25-gauge, sutureless vitrectomy and standart 20-gauge pars plana vitrectomy in idiopathic epiretinal membrane surgery: a comparative pilot study. Graefes Arch Clin Exp Ophthalmol 244:472–479

    Article  PubMed  Google Scholar 

  7. 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 

  8. Siqueira RC, Gil AD, Jorge R (2007) Retinal detachment surgery with silicone oil injection in transconjunctival sutureless 23-gauge vitrectomy. Arq Bras Oftalmol 70(6):905–909

    Article  PubMed  Google Scholar 

  9. Narayanan R, Tibra N, Mathai A, Chhablani J, Kuppermann BD (2012) Sutureless 23-gauge versus 20-gauge vitrectomy with silicone oil injection in rhegmatogenous retinal detachment. Retina 32(5):1013–1016

    Article  PubMed  Google Scholar 

  10. Riemann CD, Miller DM, Foster RE, Petersen MR (2007) Outcomes of transconjunctival sutureless 25-gauge vitrectomy with silicone oil infusion. Retina 27(3):296–303

    Article  PubMed  Google Scholar 

  11. Altan T, Acar N, Kapran Z, Unver YB, Ozdogan S (2008) Transconjunctival 25-gauge sutureless vitrectomy and silicone oil injection in diabetic tractional retinal detachment. Retina 28(9):1201–1206

    Article  PubMed  Google Scholar 

  12. Shah CP, Ho AC, Regillo CD, Fineman MS, Vander JF, Brown GC (2008) Short-term outcomes of 25-gauge vitrectomy with silicone oil for repair of complicated retinal detachment. Retina 28(5):723–728

    Article  PubMed  Google Scholar 

  13. American Society of Retinal Specialists (2004–2013) Preferences and Trends survey results from 2004–2013. https://www.asrs.org/members/login?returnUrl=%2Fcontent%2Fdocuments%2F_2015-pat-survey-results.pdf. Accessed 23 Apr 2015

  14. Oshima Y, Wakabayashi T, Sato T, Ohji M, Tano Y (2010) A 27-gauge instrument system for transconjunctival sutureless microincision vitrectomy surgery. Ophthalmology 117:93–102

    Article  PubMed  Google Scholar 

  15. Riemann CD (2011) Initial impressions with 27-gauge vitrectomy. The first generation of a new surgical modality shows promise. Retina Today Jan/Feb, pp 85–87

  16. Rizzo S, Barca F (2013) Twenty-seven-gauge sutureless microincision vitrectomy surgery: a new frontier. Retin Today 8(3):37–40

    Google Scholar 

  17. Schaal S, Ozkok A, Nesmith B (2014) 27-gauge vitrectomy surgery: smaller is better. Retin Today 9(2):24–32

    Google Scholar 

  18. Khan MA, Shahlaee A, Toussaint B, Hsu J, Sivalingam A, Dugel PU, Lakhanpal RR, Riemann CD, Berrocal MH, Regillo CD, Ho AC (2016) Outcomes of 27-gauge microincision vitrectomy surgery for posterior segment disease. Am J Ophthalmol 161:36–43

    Article  PubMed  Google Scholar 

  19. The Silicone Study Group (1992) Vitrectomy with silicone oil or sulfur hexafluoride gas in eyes with severe proliferative vit- reoretinopathy: results of a randomized clinical trial. Silicone study report 1. Arch Ophthalmol 110:770–779

    Article  Google Scholar 

  20. Abrams WG, Azen SP, McCuen BW, Flynn HW Jr, Lai MY, Ryan SJ (1997) Vitrectomy with silicone oil or long-acting gas in eyes with severe proliferative vitreoretinopathy: results of additional and long-term follow-up. Silicone study report 11. Arch Ophthalmol 115:335–344

    Article  CAS  PubMed  Google Scholar 

  21. The Silicone Study Group (1992) Vitrectomy with silicone oil or perfluoropropane gas in eyes with severe proliferative vitreoretinopathy: results of a randomized clinical trial. Silicone study report 2. Arch Ophthalmol 110:780–792

    Article  Google Scholar 

  22. Ibarra MS, Hermel M, Prenner JL, Hassan TS (2005) Longer-term outcomes of transconjunctival sutureless 25-gauge vitrectomy. Am J Ophthalmol 139(5):831–836

    Article  PubMed  Google Scholar 

  23. Oliveira LB, Reis PA (2007) Silicone oil tamponade in 23-gauge transconjunctival sutureless vitrectomy. Retina 27(8):1054–1058

    Article  PubMed  Google Scholar 

  24. Dugel PU, Zhou J, Abulon DJ, Buboltz DC (2012) Tissue attraction associated with 20-gauge, 23-gauge, and enhanced 25-gauge dual-pneumatic vitrectomy probes. Retina 32(9):1761–1766

    Article  PubMed  Google Scholar 

  25. Dugel PU, Abulon DJ, Dimalanta R (2015) Comparison of attraction capabilities associated with high-speed, dual-pneumatic vitrectomy probes. Retina 35(5):915–920

    Article  PubMed  Google Scholar 

  26. Nagpal M, Wartikar S, Nagpal K (2009) Comparison of clinical outcomes and wound dynamics of sclerotomy ports of 20, 25, and 23 gauge vitrectomy. Retina 29(2):225–231

    Article  PubMed  Google Scholar 

  27. Mentens R, Stalmans P (2009) Comparison of postoperative comfort in 20 gauge versus 23 gauge pars plana vitrectomy. Bull Soc Belge Ophtalmol 311:5–10

    Google Scholar 

  28. Avitabile T, Castiglione F, Bonfiglio V, Castiglione F (2010) Transconjunctival sutureless 25-gauge versus 20-gauge standard vitrectomy: correlation between corneal topography and ultrasound biomicroscopy measurements of sclerotomy sites. Cornea 29(1):19–25

    Article  PubMed  Google Scholar 

  29. Hsu J, Chen E, Gupta O, Fineman MS, Garg SJ, Regillo CD (2008) Hypotony after 25-gauge vitrectomy using oblique versus direct cannula insertions in fluid-filled eyes. Retina 28(7):937–940

    Article  PubMed  Google Scholar 

  30. Woo SJ, Park KH, Hwang JM, Kim JH, Yu YS, Chung H (2009) Risk factors associated with sclerotomy leakage and postoperative hypotony after 23-gauge transconjunctival sutureless vitrectomy. Retina 29(4):456–463

    Article  PubMed  Google Scholar 

  31. Tan HS, Mura M, de Smet MD (2009) Iatrogenic retinal breaks in 25-gauge macular surgery. Am J Ophthalmol 148(3):427–430

    Article  PubMed  Google Scholar 

  32. Scott IU, Flynn HW Jr, Dev S, Shaikh S, Mittra RA, Arevalo JF, Kychenthal A, Acar N (2008) Endophthalmitis after 25-gauge and 20-gauge pars plana vitrectomy: incidence and outcomes. Retina 28(1):138–142

    Article  PubMed  Google Scholar 

  33. Bamonte G, Mura M, Stevie Tan H (2011) Hypotony after 25-gauge vitrectomy. Am J Ophthalmol 151(1):156–160

    Article  PubMed  Google Scholar 

  34. Osawa S, Oshima Y (2014) 27-gauge vitrectomy. Dev Ophthalmol 54:54–62

    Article  PubMed  Google Scholar 

  35. Gorovoy IR, Stewart JM (2013) 360° subconjunctival silicone oil after unsutured 23-gauge vitrectomy. Eye (Lond) 27(7):894–895

    Article  CAS  Google Scholar 

  36. El-Batarny AM (2008) Transconjunctival sutureless 23-gauge vitrectomy for vitreoretinal diseases: outcome of 30 consecutive cases. Middle East Afr J Ophthalmol 15(3):99–105

    Article  PubMed  Google Scholar 

  37. Scott IU, Flynn HW Jr, Murray TG, Smiddy WE, Davis JL, Feuer WJ (2005) Outcomes of complex retinal detachment repair using 1000- vs 5000-centistoke silicone oil. Arch Ophthalmol 123(4):473–478

    Article  CAS  PubMed  Google Scholar 

  38. United States Food and Drug Administration (ongoing study) Clinical comparison of 27 + ® and 23-gauge ULTRAVIT® 7500 Cpm vitrectomy outcomes https://clinicaltrials.gov/ct2/show?term=27+vitrectomy&rank=1 Accessed 27 Feb 2016

  39. Da Mata AP, Riemann CD, Nehemy MB, Foster RE, Petersen MR, Burk SE (2005) Indocyanine green-assisted internal limiting membrane peeling for macular holes to stain or not to stain? Retina 25(4):395–404

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Cincinnati Eye Institute and Department of Opthalmology, University of Cincinnati School of Medicine, Cincinnati, OH, USA

    Okan Toygar, Cindy W. Mi, Daniel M. Miller & Christopher D. Riemann

  2. Department of Ophthalmology, Faculty of Medicine, Bahcesehir University, Istanbul, Turkey

    Okan Toygar

Authors
  1. Okan Toygar
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Cindy W. Mi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Daniel M. Miller
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Christopher D. Riemann
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Christopher D. Riemann.

Ethics declarations

Funding

This work was supported in part by Research to Prevent Blindness, Inc., New York, NY, in the form of an unrestricted research grant to the University of Cincinnati, Department of Ophthalmology. The sponsor had no role in the design or conduct of this research.

Conflict of interest

DMM is a consultant to Synergetics USA, Inc. CDR is a consultant to Alcon Laboratories and MedOne Surgical, Inc.

OT and CWM certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; or expert testimony or patent-licensing arrangements) or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

For this type of study (retrospective study), formal consent is not required. Informed consent for the surgical procedure was obtained from all individual participants.

No identifying information about participants is available in the article.

Additional information

This study was performed at the Cincinnati Eye Institute and University of Cincinnati, Department of Ophthalmology

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Toygar, O., Mi, C.W., Miller, D.M. et al. Outcomes of transconjunctival sutureless 27-gauge vitrectomy with silicone oil infusion. Graefes Arch Clin Exp Ophthalmol 254, 2111–2118 (2016). https://doi.org/10.1007/s00417-016-3355-5

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00417-016-3355-5

Keywords

Search

Navigation