Transconjunctival sutureless 20-G pars plana vitrectomy for the management of diabetic vitreous hemorrhage

Abstract

ObjectiveThis study aimed to evaluate the short-term safety and efficacy of pars plana vitrectomy with a 20-G transconjunctival cannulated sutureless system for the management of diabetic vitreous hemorrhage.Patients and methodsThe study included 30 eyes of 30 patients with diabetic vitreous hemorrhage; 18 (60%) of the patients were women and 12 (40%) were men and their average age was 55 ± 9.3 years. All patients underwent surgery under general anesthesia. Using a 20-G MVR blade and a 15-20° entry angle, three limbus-radial, transconjunctival, pars plana sclerotomies were fashioned with an oblique intrascleral passage that was self-sealing (sutureless) at the end of surgery. The collected data included patients' age, sex, intraocular pressure, visual acuity, duration of surgery, and postoperative subjective pain; intraoperative or postoperative complications were also evaluated. Patients were evaluated postoperatively using the same preoperative tests. Visual acuity was measured at 1 week, 1 month, and 3 months postoperatively and also at all follow-up visits after that period.ResultsThe mean total operative time was 27.4 ± 4.5 min (range 20-35 min) and the mean time of vitrectomy was 13 ± 5.5 min. There was a significant improvement in visual acuity at 3 months of follow-up (P = 0.0001). The mean intraocular pressure changed from 15.2 ± 4 mmHg preoperatively to 15.4 ± 6 mmHg at 1 month; this was not statistically significant (P > 0.05). No serious complications such as endophthalmitis or retinal detachment were detected during the follow-up period. No patient developed sclerotomy-related complications.ConclusionThe transconjunctival sutureless 20-G vitrectomy leads to a short operative time, improved patient comfort, and rapid visual improvement with fewer postoperative complications and inflammation, in addition to the advantage of less expensive instruments. Further trials with contemporary equipment and a larger sample size are recommended.