Vitrectomia transconjuntival: dados preliminares com o sistema Millennium TSV-25

Abstract

To report the preliminary surgical results of pars plana vitrectomy with a transconjunctival technique using the TSV-25 Millennium system. Twenty consecutive patients (20 eyes) that underwent transconjunctival vitrectomy with the TSV-25 Millennium system, between July 2003 and January 2004, were prospectively postoperatively followed for a minimum period of one month. Eyes with macular hole, epiretinal membrane, macular edema, rhegmatogenous retinal detachment, endophthalmitis, and vitreous hemorrhage with or without tractional retinal detachment were included. Intra and post-operative complications and difficulties were recorded. All 20 patients completed at least one month postoperative follow-up. There were 4 macular holes, 2 epiretinal membranes, 2 cystoid macular edemas post-cataract surgery, 1 diabetic macular edema, 5 rhegmatogenous retinal detachments, 5 vitreous hemorrhages (2 associated with tractional retinal detachment), and 1 endophthalmitis. Mean postoperative day one intraocular pressure was 15.7 mmHg (6-46 mmHg) and at one postoperative month it was 14.2 mmHg (8-22 mmHg). There were no cases of sclerotomy-related retinal breaks, postoperative endophthalmitis, or ocular hypotony. Three of 5 eyes (60%) with retinal detachment needed further surgical intervention (all pseudophakic) and 4 of 5 eyes (80%) with vitreous hemorrhage had postoperative residual hemorrhage. All cases with macular diseases and phakic retinal detachments were successful with one surgery. This transconjunctival vitrectomy technique showed as its main benefits the low incidence of sclerotomy-related breaks and postoperative ocular hypertension. An adequate case selection seems to be crucial.