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Middle East African Journal of Ophthalmology Middle East African Journal of Ophthalmology
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ORIGINAL ARTICLE
Year : 2008  |  Volume : 15  |  Issue : 3  |  Page : 99-105

Transconjunctival sutureless 23-gauge vitrectomy for vitreoretinal diseases: Outcome of 30 consecutive cases


Department of Ophthalmology, Magrabi Eye and Ear Hospital, Muscat, Sultanate of Oman, Oman

Correspondence Address:
Ashraf M El-Batarny
Tanta University, Egypt; Chief of Vitreoretinal Service, Magrabi Eye and Ear Center, PO Box 513, PC 112, Muscat, Sultanate of Oman, Oman

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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0974-9233.51983

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Background : To describe the initial experience, effectiveness, and safety profile of 23-gauge instrumentation for a variety of vitreoretinal conditions. Methods : A retrospective review of 30 consecutive 23-gauge vitrectomy cases done by a single vitreoretinal surgeon for various posterior segment conditions was done. All surgeries were performed using the two-step 23-gauge system developed by Dutch Ophthalmic Research Center (DORC). All patients had at least 3-month follow-up. Main outcome measures included surgical success, visual acuity, intraocular pressure, and operative complications. Results : Mean follow-up was 7.7 months (range 3-12 months). Indications for surgery included rhegmatogenous retinal detachment (n=8), nonclearing vitreous hemorrhage (n=6), tractional retinal detachment (n=5), macular hole (n=5), epiretinal membrane (n=3), retained lens fragments (n=2) and endophthalmitis (n=1). Gas tamponade was used in 18 eyes (60%) and silicone oil in six eyes (20%). Mean overall preoperative visual acuity was 20/1053 and final acuity was 20/78 ( P = 0.001). Mean intraocular pressure after 6 hours was 15.1mmHg (range 4-25 mmHg) and on postoperative day one was 14.5 mmHg (range 2-21 mmHg). Four eyes (13.3%) required suturing of sclerotomy intraoperatively. Conversion to 20-gauge was done in one eye (3.3%). Hypotony was reported in one eye (3.3%) postoperatively. Subconjunctival silicone oil reported in one eye (3.3%). There were no postoperative complications of endophthalmitis, retinal or choroidal detachment. Conclusion : 23-gauge transconjunctival sutureless vitrectomy was effective in the management of wide variety of vitreoretinal surgical indications. The safety profile compared favorably with published rates for 25-gauge systems.


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