Abstract
BackgroundCharacteristic complications have been reported for transconjunctival sutureless vitrectomy, such as postoperative sclerotomy leakage and postoperative hypotony. Particular attention to sclerotomy closure is required in cases of silicone oil tamponade, because postoperative supplementation of silicone oil implies reoperation, whereas postoperative supplement of gas is comparatively easy. This study investigated sclerotomy closure in cases of silicone oil tamponade using 25-gauge transconjunctival sutureless vitrectomy.MethodsWe enrolled 19 consecutive eyes with silicone oil injection (Group A, self-sealing sclerotomies, n = 10) (Group B, sutured sclerotomies, n = 9) and 10 eyes with silicone oil removal (Group C, self-sealing sclerotomies) using 25-gauge TSV. Postoperative intraocular pressure was compared between Groups A and B, and between Groups A and C using repeated-measures analysis of variance (ANOVA), one-way factorial ANOVA, and the Tukey-Kramer test.ResultsNo significant differences in age or axial length were seen among groups, but surgical time differed significantly between Group C and the other groups. Mean duration of silicone oil tamponade was 3.2 ± 1.4 months in Group C, and no sclerotomies in Group A or C required suture placement. Postoperative silicone oil leakage to the subconjunctival space was not encountered in Group A. No cases showed postoperative hypotony (defined as intraocular pressure <5 mmHg). Significant differences in intraocular pressure within the same postoperative period were not identified between Groups A and B. Conversely, significant differences in intraocular pressure within the same postoperative period were identified at postoperative days 1 and 2, although not at postoperative week 1 or postoperative month 1 between Groups A and C.ConclusionsThe procedure for sclerotomy closure seems to have little influence on postoperative intraocular pressure in eyes with silicone oil tamponade using 25-gauge transconjunctival sutureless vitrectomy, because silicone oil tamponade may avoid postoperative hypotony by decreasing sclerotomy leakage in the early postoperative period.Electronic supplementary materialThe online version of this article (doi:10.1186/s12886-015-0159-z) contains supplementary material, which is available to authorized users.
Highlights
Characteristic complications have been reported for transconjunctival sutureless vitrectomy, such as postoperative sclerotomy leakage and postoperative hypotony
Characteristic complications of transconjunctival sutureless vitrectomy (TSV) have been reported to include postoperative sclerotomy leakage and postoperative hypotony [4,5,6,7,8,9], so surgeons have been apprehensive about the potential weakness of self-sealing sclerotomy
Lin et al [10] suggested that using an oblique sclerotomy incision rather than a conventional sclerotomy incision reduced the incidence of postoperative sclerotomy leakage because of its natural self-sealing effect, and Shimozono et al [11] found that a three-step incision, similar to the self-sealing incision in cataract surgery, reduced postoperative hypotony
Summary
Characteristic complications have been reported for transconjunctival sutureless vitrectomy, such as postoperative sclerotomy leakage and postoperative hypotony. Particular attention to sclerotomy closure is required in cases of silicone oil tamponade, because postoperative supplementation of silicone oil implies reoperation, whereas postoperative supplement of gas is comparatively easy. This study investigated sclerotomy closure in cases of silicone oil tamponade using 25-gauge transconjunctival sutureless vitrectomy. The characteristic procedure in TSV compared with conventional 20-gauge vitreotomy is sutureless sclerotomy; in other words, self-sealing sclerotomy. Characteristic complications of TSV have been reported to include postoperative sclerotomy leakage and postoperative hypotony [4,5,6,7,8,9], so surgeons have been apprehensive about the potential weakness of self-sealing sclerotomy. This study examined sclerotomy closure in cases of SO tamponade using 25-gauge TSV
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