The Safety and Efficacy of Transconjunctival Sutureless 23-gauge Vitrectomy

Abstract

PurposeTo evaluate the efficacy and safety of vitreoretinal surgery using a 23-gauge transconjunctival sutureless vitrectomy (TSV) system for various vitreoretinal diseases.MethodsA retrospective, consecutive, interventional case series was performed for 40 eyes of 40 patients. The patients underwent vitreoretinal procedures using the 23-gauge TSV system, including idiopathic epiretinal membrane (n=7), vitreous hemorrhage (n=11), diabetic macular edema (n=10), macular hole (n=5), vitreomacular traction syndrome (n=5), diabetic tractional retinal detachment (n=1), and rhegmatogenous retinal detachment (n=1). Best corrected visual acuity (BCVA), intraocular pressure (IOP), and intra- and post-operative complications were evaluated.ResultsIntraoperative suture placement was necessary in 3 eyes (7.5%). The median BCVA improved from 20/400 (LogMAR, 1.21±0.63) to 20/140 (LogMAR, 0.83±0.48) at 1 week (p=0.003), 20/100 (LogMAR, 0.85±0.65) at 1 month (p=0.002), 20/100 (LogMAR, 0.73±0.6) at 3 months (p=0.001). In 1 eye, IOP was 5 mmHg at 2 hours and 4 mmHg at 5 hours, but none of the eyes showed hypotony after 1 postoperative day. No serous postoperative complications were observed during a mean follow-up of 8.4±3.4 months (range 3-13 months)ConclusionsThe 23-gauge TSV system shows promise as an effective and safe technique for a variety of vitreoretinal procedures. It appears to be a less traumatic, more convenient alternative to 20-gauge vitrectomy in some indications.