23-gauge Transconjunctival Vitrectomy Research Articles

Active silicone oil removal with 23 gauge transconjunctival system; ‘'Doganay silicone oil extraction system''

Aim: To describe a new and simple silicone oil removal method with 23-gauge (G) transconjunctival vitrectomy system. Material and Methods: This is a prospective, single center, interventional clinical trial. A hundred thirty-three eyes of 133 patients were enrolled in this study. 1000 centistoke (cSt) silicone oil was removed with our new method. Main outcome measurements were silicone oil removal time, number of sutured 23 G sclerotomy sites, intraoperative and postoperative complications, preoperative and postoperative intraocular pressure (IOP) alterations, and preoperative and postoperative visual acuity changes. Results: The mean time between pars plana vitrectomy surgery with silicone oil endotamponade and silicone oil removal was 8.5±3.5 months. Mean silicone oil removal time was 141.7±37.7 seconds. 210 of total 293 sclerotomies sites required suture. A statistically significant decrease in postoperative IOP was found only on day 1 (p

Combined 23-gauge transconjunctival vitrectomy and scleral fixation of intraocular lens without conjunctival dissection in managing lens complications

BackgroundTo evaluate the safety and efficacy of combined 23-gauge transconjunctival pars plana vitrectomy and scleral fixation of intraocular lens (IOL) without conjunctival dissection.MethodsA retrospective study in Chang Gung Memorial Hospital, Keelung and Taoyuan, Taiwan. Patients receiving combined 23-gauge transconjunctival pars plana vitrectomy and scleral fixation of IOL without conjunctival dissection were enrolled. The ocular findings, causes of lens complication, surgical procedures, type of IOL used, and complications were documented.ResultsWe included 40 eyes from 39 patients (27 male, 12 female) with a mean age of 59.5 [standard deviation (±) 14.8] years old. The mean follow-up duration was 6.8 ± 5.4 months. The cause of lens complications was ocular trauma in 24 (60%) eyes, cataract surgery complications in 11 (28%) eyes, and spontaneous subluxation of crystalline lens in 5 (13%) eyes. The overall best corrected visual acuity (BCVA) (logMAR) improved from 1.359 ± 0.735 to 0.514 ± 0.582 (p < 0.001). The BCVA also improved significantly in each group with different causes of lens complications. Preoperative BCVA was the only factor associated with the postoperative visual outcome (p = 0.008). Most surgery-related complications were self-limited, including mild vitreous hemorrhage (5%), microhyphema (5%), transient elevated intraocular pressure (3%), and transient hypotony (3%). Cystoid macular edema and IOL decentration was found in 3 (8%) eyes and 1 (3%) eye respectively.ConclusionsCombined 23-gauge transconjunctival vitrectomy and scleral fixation of IOL without conjunctival dissection is effective and safe in managing a wide variety of lens complications, with good postoperative comfort and visual recovery.Trial registrationRetrospective study, not applicable.

23-gauge transconjunctival vitrectomy for posterior segment intraocular foreign bodies.

This study is a report of the outcomes of 23-gauge (G) transconjunctival vitrectomy (TV) performed to treat a posterior segment intraocular foreign body (IOFB). The data of 14 eyes of 14 patients who underwent 23-G TV for the removal of a posterior segment IOFB were reviewed in this study. Surgery was initiated with a 23-G system in each case and the posterior segment IOFB was removed through the enlarged sclerotomy site. All of the patients were male. The mean age of the patients was 36.6+-11.0 years. The foreign body (FB) was located in the vitreous in 11 eyes and in the retina in 3 eyes. Before the 23-G TV, complicated cataract was detected in 6 eyes, vitreous hemorrhage was detected in 5 eyes, and retinal detachment was detected in 1 eye. The size of the FB ranged from 3 mm to 7 mm; 12 of the FBs were metallic and 2 were glass. Silicone oil was used as a tamponade agent in 5 eyes and gas tamponade (C3F8) was used in 4 eyes. The mean follow-up time was 8.15+-2.9 months. At the last examination, of the 14 eyes included in the study, the visual acuity (VA) was 0.1 or better in 10 eyes and less than 0.1 in 4 eyes because 2 eyes had peri-macular scar, 1 eye had massive sub-epiretinal membrane and 1 eye had retinal re-detachment. 23-G TV is seen as an effective and minimally invasive technique to remove posterior segment IOFBs.

Comparison of 2 modified methods for the active removal of silicone oil with a 23-gauge transconjunctival vitrectomy system.

To report and compare 2 modified approaches for the active removal of silicone oil (ROSO) with a 23-gauge transconjunctival vitrectomy system.This prospective single blinded study was conducted from January 2015 to December 2016. Eighty-nine eyes of 86 patients who underwent silicone oil removal were enrolled. Patients were randomly divided into either group A or B. In group A, the fluid–air exchange tube was connected to a 1 mL syringe with the plunger removed and the tip was dilated with a hemostat so that it fit into the cap of the 23-gauge cannula to form a seal for oil drainage. In group B, the tip of the syringe was closely attached to the cap of the 23-gauge cannula by a tube adaptor, which was salvaged from a used silicone oil inject and aspirate pack and sterilized. Main outcome measures were time required for silicone oil removal, silicone oil residual, intraoperative and postoperative complications including hypotony, bleeding, and retinal redetachment.The mean time required was 6.08 ± 0.31 minutes and 6.11 ± 0.31 minutes for groups A and B, respectively. No silicone oil residual, severe hypotony, recurrence of retinal detachment, or impairment of visual acuity were observed in either group. Conjunctival injection and hyperemia were slightly more severe in group A, but spontaneously resolved in 2 to 3 days.Both methods described in this paper were demonstrated to be safe, effective, and cost-effective for the ROSO. The syringe dilation method caused more severe conjuntival irritation, thus we suggest using the tube adaptor method for hospitals equipped with cold sterilization equipment.

Tissue plasminogen activator-assisted vitrectomy for submacular hemorrhage due to age-related macular degeneration.

Purpose:The purpose of this study was to evaluate the treatment efficacy of vitrectomy combined with subretinal recombinant tissue plasminogen activator (r-tPA) and factors affecting visual improvement in patients with submacular hemorrhage (SMH) due to neovascular age-related macular degeneration (nAMD).Materials and Methods:Medical records of 17 consecutive patients diagnosed with SMH secondary to nAMD were retrospectively reviewed. The initial surgical procedure involved a 23-gauge transconjunctival vitrectomy, subretinal r-tPA application through a self-sealing inferior retinotomy, and sulfur hexafluoride gas for tamponade in all patients. The duration, size, and thickness of the hemorrhage and the pre- and post-operative visual acuity (VA) using a Snellen chart were recorded. VA was converted to logMAR for statistical analysis.Results:The average duration and size of the SMH were 12.8 ± 18.2 days and 8.6 ± 5.3 disc areas, respectively. The mean follow-up time was 16.9 ± 4.7 months. A statistically significant visual improvement was found when comparing initial VA with postoperative best-corrected VA (BCVA) and final BCVA (Wilcoxon rank test, P ≤ 0.01). There was no significant correlation between the size of the hemorrhage and postoperative BCVA and final BCVA (Spearman's rho test). There was no statistically significant correlation between the initial VA and postoperative BCVA and final BCVA (Spearman's rho test). There was no significant correlation between the duration of hemorrhage and postoperative BCVA and final BCVA (Spearman's rho test). The preoperative thickness of hemorrhage (747.5 ± 30 μm) was not correlated with postoperative BCVA or final BCVA (Pearson's test).Conclusions:Vitrectomy combined with subretinal r-tPA injection and gas tamponade is an effective surgical intervention to preserve VA in selected patients with apparent SMH.

Secondary Angle-Closure Glaucoma Due to Posterior Synechiae of Iris Following Combined Phacoemulsification and 23-Gauge Transconjunctival Vitrectomy

ABSTRACTPurpose: To describe the clinical characteristics of eyes with secondary angle-closure glaucoma following combined phacovitrectomy. Methods: Retrospective case series. Results: Nine eyes developed angle-closure glaucoma due to iris posterior synechiae with an incidence rate of 1.82% (95% CI: 0.64 – 3%) among 493 eyes following phacovitrectomy. PDR with TRD was the most common surgical indication. Single piece IOL insertion and silicone oil were present in all cases. Fibrin in the anterior chamber was found in six eyes postoperatively. Mean degree of iris bombe was 310±79.37° at 3.55±1.87 weeks with a mean IOP of 32.56±5.89 mm of Hg. Systemic diabetes and grade of cataract were the only significant risk factors (r2 =1; p= 0.016 and 0.049, respectively). Nd:YAG laser PI relieved the angle-closure attack in all cases. Conclusion: Systemic diabetes and advanced grade of cataract are significant risk factors for secondary angle-closure glaucoma following combined phacovitrectomy.

23-gauge transconjunctival vitrectomy in eyes with pre-existing functioning filtering blebs.

BackgroundWe investigated the outcome of 23-gauge transconjunctival pars plana vitrectomy (23G PPV) for the treatment of vitreoretinal disorder in patients with prior trabeculectomy.MethodsWe retrospectively reviewed medical records of 23G PPV in 11 eyes that had functioning filtering blebs after trabeculectomy. The main outcome measures were the visual acuity, intraocular pressure (IOP) and subconjunctival fluid height in bleb by anterior segment optical coherence tomography (OCT) before and after the surgery.ResultsEyes that had 23G PPV showed improvement of visual acuity after the surgery (P =0.003). Mean IOP was 13.82 mmHg before 23G PPV and 15.82 mmHg at 6 months postoperatively, which was statistically insignificant (P = 0.758). The bleb was observed before and after surgery using anterior segment OCT, and the difference in subconjunctival fluid was not statistically significant (P =0.172).Conclusions23G PPV did not adversely affect bleb function in eyes with prior trabeculectomy.

Application of 23-gauge transconjunctival vitrectomy system in pediatric cataract surgery

Objective To evaluate the effect of lensectomy and anterior vitrectomy with 23-gauge transconjunctival vitrectomy system for pediatric cataract. Methods Seventy-one eyes of 71 cases with pediatric cataract in our hospital from January 2009 to December 2013 were retrospectively studied. The age range was 0.5 to 2.0 years old and all cases were randomly divided into two groups: group A(control group) received posterior continuous curvilinear capsularhexis combined with anterior vitrectomy; lensectomy with 23-gauge vitrectomy system was performed to group B(observation group). The visual acuity, posterior capsular opacification and other complications after operation were compared between two groups. Results There was significant difference in the improvement of best corrected visual acuity between two groups after operation (t=2.334, P<0.05). The incidence of corneal edema, iris prolapse, cystoid macular edema and retinal detachment of group B were less than those of group A (P<0.05). Conclusion 23 G vitrectomy system for lensectomy is a safe, effective and minimally invasive method for the treatment of pediatric cataract. Key words: Vitrectomy, 23-G; Cataract, congenital; Opacity, posterior capsular

Comparison of Two Scleral Incision Techniques in 23-Gauge Transconjunctival Vitrectomy

To compare two 23-gauge transconjunctival vitrectomy incision techniques, parallel and perpendicular to the alignment of scleral fibers, in terms of hypotony and postoperative intraocular pressure (IOP). Fifty-three eyes of 53 patients who underwent 23-gauge one-step trocar pars plana vitrectomy were randomly assigned to undergo scleral incision parallel (group 1, 26 eyes) or perpendicular (group 2, 27 eyes) to the limbus. Patients were observed postoperatively for wound healing, leakage, endophthalmitis, IOP, and hypotony at 1 day, 1 week, and 1, 3, 6, and 9 months. No difference in preoperative IOP was observed (P = .229). Postoperative IOP was significantly lower in group 2 (P = .009). Hypotony rates did not differ between the groups. Intraocular gas or silicone tamponade was used intraoperatively in 26 cases. In cases in which no gas or silicone was given (n = 27), IOP measurements were significantly lower in group 2 (P = .021). There was no difference in hypotony ratios for gas/silicone injection versus no injection (P = 1.00) or in postoperative visual acuity (P = .350). Visual acuity improved significantly in both groups at follow-up examinations. Parallel and perpendicular incisions resulted in similar postoperative hypotony rates, but perpendicular incisions were associated with lower IOP.

Application of 23G vitrectomy for preretinal hemorrhage and sub-inner limiting membrane hemorrhage

Objective To observe the application of 23-gauge vitrectomy in treating preretinal hemorrhage and inner limiting membrane hemorrhage.Methods The clinical data of 23-gauge vitrectomy for treatment of preretinal hemorrhage and inner limiting membrane hemorrhage in 9 cases (9 eyes) were analysed.Results The preretinal hemorrhage and inner limiting membrane hemorrhage were cleared in 9 cases,and visual acuity improved.Conclusion 23-gauge transconjunctival vitrectomy is a safe and effective surgical procedure for preretinal hemorrhage and inner limiting membrane hemorrhage with quick recovery and less complication. Key words: Preretinal hemorrhage; Inner limiting membrane hemorrhage ; 23-gauge vitrectomy system

23-gauge transconjunctival sutureless vitrectomy in treatment of post-operative endophthalmitis

To report the safety and efficacy of 23-gauge (23-G) transconjunctival vitrectomy (TSV) in the surgical management of postoperative endophthalmitis. Ten consecutive patients underwent a 23-G TSV in 2008-2010 after cataract surgery (n = 5) or filtrating surgery (n = 5), and were prospectively studied with a minimum follow-up of 6 months. TSV was performed within a median delay of 1 day after the diagnosis, after one or two injections of intravitreal antibiotics (vancomycin, ceftazidime). Conventional cultures (brain heart infusion media) and/or panbacterial PCR were performed on aqueous humor and/or vitreous samples. Initial visual acuity was less than or equal to hand motion in all cases, and clinical findings included hypopyon (80%), pupillary fibrin membrane (80%), and dense vitreitis (4+, 100%). The bacteria identified were Gram-positive cocci in 60% of the cases (coagulase-negative staphylococci, 20%; streptococcus, 40%) and Gram-negative bacilli in 10% (moraxella lacunata). All patients had central and peripheral vitrectomy (mean duration, 58.6 ± 16 min). No intraoperative complications were noted. Two patients developed retinal detachment postoperatively and were reoperated. The final visual vision was 20/400 for two patients and 20/50 or better for the other patients. 23-G TSV allows the surgeon to meet the same objectives as the 20-G technique for the treatment of endophthalmitis.

Comparison of Efficacy and Safety between Transconjunctival 23-Gauge and Conventional 20-Gauge Vitrectomy Systems in Macular Surgery

PurposeTo compare the efficacy and safety of 23-gauge transconjunctival vitrectomy with the conventional 20-gauge method in idiopathic epiretinal membrane and macular hole surgery.MethodsSixty-one consecutive patients undergoing vitrectomy for idiopathic epiretinal membrane and macular hole were recruited to either 20- or 23-gauge vitrectomy groups and prospectively evaluated. Surgical success rates, operating time, surgery-related complications, long-term visual outcomes, and postoperative ocular surface problems are compared in the two groups.ResultsThere were 31 eyes in the 20-gauge group and 33 eyes in the 23-gauge group. The macular hole closure rate after the first surgery was 83% and 90.9% in the 20-gauge and 23-gauge groups, respectively, with no significant difference between groups (p = 0.59). The success rate for idiopathic epiretinal membranes cases was 100% in both groups. There was no statistically significant difference between overall surgical times (p = 0.90). None of the patients in either group experienced postoperative complications of severe postoperative hypotony, vitreous hemorrhage or endophthalmitis, except one eye in the 20-gauge group, which was found to have retinal detachment. In both groups, statistically significant improvement in visual acuity was achieved 1-month postoperatively (p = 0.002) and thereafter at all postoperative visits (p < 0.05). The mean ocular surface scores were significantly lower in the 23-gauge group at all postoperative visits compared with the 20-gauge group scores (p = 0.001).ConclusionsTransconjunctival 23-gauge vitrectomy appears to be as effective and safe as conventional 20-gauge vitrectomy in idiopathic epiretinal membrane and macular hole surgeries.

Passive Silicone Oil Removal in 23-Gauge Transconjunctival Vitrectomy

The authors introduce a feasible technique of passive silicone oil removal via the pars plana using 23-gauge transconjunctival vitrectomy microsurgery instruments. The procedure consists of three-port transconjunctival insertion of 23-gauge microcannulas. An inferotemporal cannula is connected to an infusion line and the height of the bottle is raised. The other two open ports are used to remove intravitreal silicone oil with an externally applied cotton swab. Passive silicone oil removal was conducted using the 23-gauge system in 46 phakic or pseudophakic eyes with silicone oil of both 1,000 (n = 39) and 5,000 centistokes (n = 7). A suture was placed for one of three sclera entry sites in 17 eyes. Cataract extraction with phacoemulsification was combined with passive silicone oil removal in 14 eyes. Transient hypotony was observed in 2 eyes. No retinal redetachment or other procedure-related complications were encountered.

Clinical analysis of 23-gauge transconjunctival vitrectomy system in treating Terson' s syndrome

Objective To evaluate the effect of 23-gauge transconjunctival vitrectomy system in treating Terson syndrome,and to assess the impact of operating-timing on the prognosis.Methods 11 cases with Terson' s syndrome was treated with 23-gauge transcomjunctival vitrectomy system,some of them with peeling of epiretinal membrane,intraocular laser coagulation,tamponading of air or expansive gases.Results All patients' vitreous were clear after the surgey and the visual acuity was improved inordinately.Conclusion 23-gauge transconjunctival vitrectomy system therapy of vitreous hemorrhage in Terson' s syndrome is a safe and effective surgical procedure,which has quick recovery,simple operation and less complication.The earlier surgery is good for recovery. Key words: Terson's syndrome; Vitreous hemorrhage; 23-gauge transconjunctival vitrectomy system

Comparison of postoperative inflammation and patient discomfort scores following 23-gauge and 25-gauge transconjunctival vitrectomy

Comparison of postoperative inflammation and patient discomfort scores following 23-gauge and 25-gauge transconjunctival vitrectomy

Repositioning a dislocated intraocular lens in the ciliary sulcus using 23-gauge sutureless pars plana vitrectomy

Intraocular lens (IOL) dislocation is a common complication of phacoemulsification. We describe a technique for retrieving a dislocated IOL using 23-gauge transconjunctival sutureless pars plana vitrectomy and repositioning the IOL in the ciliary sulcus in cases with adequate capsule support. This technique provides the benefits of sutureless surgery despite the complication of a dislocated IOL.

Outcomes of 23-gauge pars plana vitrectomy in vitreoretinal diseases

PurposeThe aim of this study was to assess the efficiency and reliability of the 23-gauge (23G) transconjunctival vitrectomy system and examine possible complications of this surgical technique in a variety of vitreoretinal conditions along with early postoperative intraocular pressure (IOP) changes.Materials and methodsA total of 350 eyes of 324 patients having undergone 23G transconjunctival vitrectomy were included in this prospective study. A total of 150 (46.2%) were male and 174 (53.8%) female, with a mean age of 61.28 ± 15.67 years. Mean follow-up time was 8.3 months.ResultsMean BCVA logMARs were as follows: preoperatively 0.839 ± 0.59, postoperatively first day 2.07 ± 0.76, first week 1.14 ± 0,43, first month 0.63 ± 0.26 and last examination 0.359 ± 0.17. Mean BCVA decreased significantly (P < 0.001, P < 0.028, respectively) on postoperative first day and first week, mainly due to air or gas tamponade, and increased significantly in the first month and final control in almost all indications (P < 0.001). Postoperative mild hypotony (IOP ≤ 10 mmHg) was detected in 112 (32%) eyes on day 1 and in 59 (16.8%) eyes in week 1. While postoperative serious hypotony (≤5 mmHg) was detected in 34 (9.7%) eyes on day 1, it was not detected in any eyes at the end of the first week. None of the eyes required an additional gas tamponade or any other procedure in the early postoperative period due to hypotony. A total of 13 (3.7%) eyes were reoperated for recurrent vitreous hemorrhage; 23 (6.5%) eyes were reoperated on a second time, nine (2.5%) a third time, and 1 (0.2%) a fourth time for recurrent rhegmatogenous retinal detachment. Postoperative fibrinoid reaction was seen in 17 (4.8%) eyes on the first day and responded well to the medications. Cataract development was found in 61 (22.5%) of the 270 phakic eyes after a mean duration of 6.4 ± 3.5 months. Anatomical success was obtained in 86% of the patients and functional success in 72%.ConclusionThe 23G transconjunctival vitrectomy system is safe and effective in a wide field of vitreoretinal conditions. It is a good alternative to 20G and 25G techniques but needs some improvement mainly in regards to the instruments and related techniques; further larger controlled group studies are needed.

Comparison of disposable sutureless silicone ring and traditional metal ring in 23-gauge vitrectomy combined with cataract surgery

Background:The purpose of this prospective, interventional, comparative case series was to evaluate the efficiency and feasibility of a disposable sutureless silicone lens ring for corneal contact lens stabilization during combined 23-gauge vitrectomy and cataract surgery.Methods:We developed a ring consisting of a single silicone component with three footplates along the ring margin to fit cannulae for holding conventional contact lenses. Thirty eyes from 30 patients with cataract and vitreoretinal disease were included, and divided into two matched groups according to disease type and ring used. In Group A, we used a 23-gauge transconjunctival vitrectomy system and a disposable sutureless silicone lens ring (n = 15). In Group B, we used a 23-gauge transconjunctival vitrectomy system and a conventional metal lens ring (n = 15). The main outcome measures were: time required for vitrectomy preparation, rate of intraoperative corneal limbus bleeding, and limbus scar rate at the final follow-up visit.Results:Thirty cases were successfully completed. The average vitrectomy preparation time was less in Group A than in Group B (P < 0.01), and the average preparation time saved was 3.94 minutes. None of the Group A patients had intraoperative bleeding or postoperative scarring, whereas all 15 Group B cases had bleeding and five had scarring. There was a statistically significant difference between Group A and Group B for these complications (P ≤ 0.05).Conclusion:This report demonstrates the advantages of using a sutureless silicone ring during combined 23-gauge vitrectomy and cataract surgery. Using this method could allow extra time for the surgeon to pay more attention to complex vitreoretinal procedures.

Incidence of retinal detachment following 23-gauge vitrectomy in idiopathic epiretinal membrane surgery

Editor, There is increasing debate about the pros and cons of sutureless microincision transconjunctival vitrectomy (TSV) surgery (Grosso & Panico 2009) in the macular surgery. The 23-gauge TSV surgery was introduced to our Retina Service in October 2005. All patients underwent single-step 3-port 23-gauge core vitrectomy dye-assisted (triamcinolone acetonide to identify the hyaloid + infracyanine green to identify the internal limiting membrane) using Accurus or Dorc Vitrector. The 23-G vitrectomy system (3D mode) was set at a cutting speed of 2500–1800 cuts per minute, infusion pressure of 20 or 40 mmHg and aspiration pressure from 40 to 350–450 mmHg. All procedures were performed under the DORC (Zuidalnd–Holland) disposable flat vitrectomy lens (Cod DR 1284 –DD), in local anaesthesia. Postoperative retinal detachment occurred in two of the 166 consecutive eyes (median age 70, 95 M, 71 F) after 23-gauge TSV surgery (1.2%) in idiopathic epiretinal membrane surgery from October 2005 to May 2009. The retinal detachment is a serious complication after vitrectomy, especially for macular surgery. In recent series of patients who underwent 23-gauge vitrectomy study for epiretinal membrane surgery, the retinal detachment occurred from 0% (Hikichi et al. 2009) to 1.6% of cases. (Haas et al. 2010) The incidence of postoperative retinal detachment following 25-gauge vitrectomy surgery is also reported low in the literature. (Tan et al. 2009). We have retrospectively analysed the clinical charts of patients, and we have found that the two cases of retinal detachment occurred in the first consecutive subgroup of patients. The pathogenesis of retinal detachment in small-gauge vitrectomy can be correlated to the following factors (Parolini et al. 2010): Type of vitrectomy and induction of iatrogenic breaks: incomplete vitrectomy, i.e. core vitrectomy versus vitrectomy as complete as possible plus endolaser; aspiration power and type of duty cycle. We analysed each of these different factors: We perform a core vitrectomy, and therefore a criticism of the technique could be that the residual vitreous in the periphery may cause retinal tractions. However, we have not found retinal breaks at the site of sclerotomies in our series after a scrupulous full 360-degree internal search at the end of each procedure. We know that the duty cycle is extremely important because it may determine possible vitreous traction and consequently retinal tears. Therefore, we set the aspiration flow up to maximum 350 mmHg instead of 450 mmHg after the first 50 cases. Since this modification, no other cases of retinal detachment occurred. We are uncertain about the role of the internal tamponade: some surgeons claim that a BSS – air exchange may help to close the sclerotomies and reduce the risk of postoperative retinal detachment, but further studies are required to validate these preliminary data. We think it is important to share our surgical experience with the scientific community. Further, we are aware about the possible bias publication when we deal with negative results in new surgical techniques. In conclusion, the 23-gauge core vitrectomy with aspiration power of maximum 350 mmHg is a safe technique to treat idiopathic epiretinal membranes. This Study was supported by Compagnia di San Paolo, Torino, Italy (protocollo n 29 SD/FA 2007.3149).

Comparison of Intraocular Pressure Between Sutureless and Sutured 23-gauge Vitrectomy

Purpose: To compare 23-gauge transconjunctival sutureless vitrectomy (TSV) and sutured vitrectomy in the aspect of intraocular pressure (IOP) changes and complications. Methods: Through a retrospective chart review, 45 sutureless patients (48 eyes) and 48 sutured patients (52 eyes) who had undergone 23-gauge transconjunctival vitrectomy by one surgeon (J.H. Sohn) were compared. IOP was measured routinely pre-operativley, at 1 day, 1 week, and 1 month post-operatively. Postoperative IOP, hypotony (IOP