Primary 23-gauge sutureless vitrectomy for rhegmatogenous retinal detachment

• Main Authors: Mario R Romano, Ronald Das, Carl Groenwald, Theo Stappler, Joaquin Marticorena, Xavier Valldeperas, David Wong, Heinrich Heimann
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2012-01-01
• Series: Indian Journal of Ophthalmology
• Subjects: Band-shaped keratopathy; corneal dystrophy; phototherapeutic keratectomy; phototherapeutic keratectomy with amniotic membrane grafts; scar; and Salzmann nodular degeneration; Kaplan Meier survival analysis; multivariate Cox Proportional Hazard Regression analysis; optical penetrating keratoplasties; Myopia; phakic refractive intraocular lens; refractive surgery; 23-Gauge vitrectomy; rhegmatogenous retinal detachment; sutureless vitrectomy
• Online Access: http://www.ijo.in/article.asp?issn=0301-4738;year=2012;volume=60;issue=1;spage=29;epage=33;aulast=Romano
• ISSN: 0301-4738; 1998-3689

Aims : To report a prospective non-comparative consecutive interventional study on the safety and efficacy of 23-Gauge transconjunctival sutureless pars plana vitrectomy for primary rhegmatogenous retinal detachment (RRD). Materials and Methods: Fifty eyes of 50 consecutive patients were recruited between June 2007 and January 2008. All surgeries were performed using the one-step 23-Gauge system with angled incisions. The surgical protocol consisted of a minimum of eight clinical visits: baseline, 1 day, 1 week, 1-, 3- and 6- months after the initial surgery. The endpoints were anatomical, functional results and complications arising from the surgery. Results : Anatomical success was achieved in 82% of cases (41 out of 50) with single surgery and rose to 98% (49 out of 50) with additional surgery. Mean visual acuity improved from logMAR 0.48(SD 0.36) to 0.26(SD 0.31), P < 0.001. Two cases with ocular hypotony, defined as an intraocular pressure ≤ 6mmHg, that were associated with a choroidal detachment were seen. Conclusions : Acceptable anatomical and functional success rates can be achieved with primary 23-Gauge transconjunctival sutureless vitrectomy for RRD. We found that the approach technique is different from conventional vitrectomy and the complications arising from post surgical hypotony and leakage from sclerotomies are potentially higher compared to 20-Gauge vitrectomy.