J Korean Ophthalmol Soc.  2008 Jan;49(1):65-70. 10.3341/jkos.2008.49.1.65.

A Combination of 23-gauge and 20-gauge Transconjunctival Sutureless Vitrectomy

• Jin SY
• Choi MJ
• Kim CG
• Kim JW

• KMID: 2211184
• DOI: http://doi.org/10.3341/jkos.2008.49.1.65

Abstract

PURPOSE: To describe the clinical experience and safety profile of a combination of 23-gauge and 20-gauge transconjunctival sutureless vitrectomy (TSV)
METHODS
Thirty-seven eyes of thirty-seven consecutive patients who underwent 23-gauge combined with 20-gauge transconjunctival vitrectomy surgery by a single surgeon from August 2006 through December 2006 were reviewed retrospectively for surgical indications, wound problems, and postoperative complications.
RESULTS
Thirty-seven eyes, including eyes with proliferative diabetic retinopathy (n=24), macular hole (n=3), epiretinal membrane (n=3), vitreous hemorrhage due to branch retinal vein occlusion and choroidal neovascular membrane (n=3), vitreous opacity secondary to uveitis (n=1), rhegmatogenous retinal detachment (n=1), and vitreoretinal traction syndrome (n=1), underwent operation. Seven eyes at 23-gauge sclerotomy sites and 15 eyes at 20-gauge sclerotomy sites had subconjunctival hemorrhage. Three eyes required sutures at 20-gauge sclerotomy sites intraoperatively due to wound leakage. One wound hemorrhage occurred at a 23-guage sclerotomy site. Vitreous hemorrhage (4 eyes), hyphema (2 eyes), and vitreous hemorrhage with hyphema (1 eye) occurred postoperatively. Postoperative hypotony, retinal detachment, and other complications did not occur.
CONCLUSIONS
A combination of 23-gauge and 20-gauge transconjunctival sutureless vitrectomy which was created by modifying transconjunctival sutureless vitrectomy systems published previously guarded against sclerotomy wounds and a variety of vitreoretinal surgical indications.

Keyword

Self-sealing sclerotomy; Transconjunctival sutureless vitrectomy

MeSH Terms

Choroid
Diabetic Retinopathy
Epiretinal Membrane
Eye
Hemorrhage
Humans
Hyphema
Membranes
Retinal Detachment
Retinal Perforations
Retinal Vein Occlusion
Retrospective Studies
Sutures
Traction
Uveitis
Vitrectomy
Vitreous Hemorrhage

Figure

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  Figure 1. (A) Standard position of two 23-guage microcannulas and 20-guage self-sealing sclerotomy in the left eye (surgeon’s view). Note the tunnel-shaped opening of cannulas and a special pressure plate for easy insertion of the vitreoretinal instruments.(B) Pressure plate which is sutured at 20-gauge self-sealing sclerotomy to prevent operative chemosis. The size of internal opening was 2 mm×1.5 mm for movement of 20-gauge instruments. 4 notches were suture sites for fixation of plate on the conjunctiva and sclera

Reference

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