Abstract
To elucidate the early surgical advantages of a 23-gauge trocar combined with a one-directional valve system in transconjunctival pars plana vitrectomies. Early surgical results of 432 eyes of 432 patients (190 female and 242 male) who underwent 23-gauge (23G) transconjunctival sutureless vitrectomies (TSV) were evaluated. Sixty-three patients out of 432 underwent a second operation, 29 of them underwent silicone oil extraction, and 34 had phacoemulsification surgery with the help of vitreous infusion. If any sign of leakage was observed after the withdrawal of the cannulae, a suture was applied at the conjunctiva-scleral opening site. A total of 21 (4.8%) patients in the first operation and 7 (11.1%) cases in the second operation needed suture in at least 1 sclerotomy site. No one had intraoperative hypotony. On postoperative day 1, 37 initial surgery patients and 3 second TSV patients had hypotony; all of them resolved spontaneously 1 week after surgery. No one developed choroidal effusions or detachment. Intraocular pressure spikes more than 22 mmHg in day 1 occurred in 18 eyes after initial TSV; 6 of them had gas and 4 eyes had silicone tamponade. 23G TSV is an effective and safe procedure for both first vitreoretinal surgery and second intraocular surgeries in eyes that had TSV previously.
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