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Graefe's Archive for Clinical and Experimental Ophthalmology

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01-10-2009 | Retinal Disorders

Surgically induced astigmatism in combined phacoemulsification and vitrectomy; 23-gauge transconjunctival sutureless vitrectomy versus 20-gauge standard vitrectomy

Authors: Dong Ho Park, Jae Pil Shin, Si Yeol Kim

Published in: Graefe's Archive for Clinical and Experimental Ophthalmology | Issue 10/2009

Abstract

Background

To study the surgically induced astigmatism (SIA) in combined phacoemulsification with 23-gauge transconjunctival sutureless vitrectomy (TSV) versus combined phacoemulsification with 20-gauge standard vitrectomy.

Methods

This is a prospective comparative study comprised of 40 eyes from 37 consecutive patients. Twenty eyes (19 patients) underwent combined phacoemulsification and 23-gauge TSV, and 20 eyes (18 patients) underwent combined phacoemulsification and 20-gauge standard vitrectomy. Corneal topography was obtained preoperatively and postoperatively at weeks 1, 4, 8, and 12. Main outcome measurement was SIA consisting of astigmatic amplitude and axis from cross cylinder form calculated by rectangular coordinate method using the Holladay-Cravy-Koch formula.

Results

The mean SIA was 1.07 ± 0.57 diopters (D) in the 23-gauge TSV group and 2.09 ± 0.81 D in the 20-gauge group at postoperative week 1. SIA of both groups at weeks 4, 8, and 12 significantly decreased from the SIA at postoperative week 1 (p < 0.0001 for all 3 weeks). SIA of the 23-gauge TSV group was significantly less than that of the 20-gauge standard vitrectomy group at each postoperative period (p = 0.001). SIA of the gas tamponade group in the 23-gauge TSV was significantly greater than that of the non-gas tamponade group at postoperative week one (p = 0.039). Shifts of axis to other meridians returned to preoperative meridian in 12 eyes (85.7%) for the 23-gauge group and seven eyes (43.8%) for the 20-gauge group.

Conclusion

Combined phacoemulsification and pars plana vitrectomy (23-gauge and 20-gauge) could induce significant SIA at postoperative week 1, and decrease over 3 months. However, 23-gauge TSV showed less SIA and early stabilization compared to the 20-gauge standard vitrectomy.

Fujii GY, De Juan E, Jr HMS, Chang TS, Pieramici DJ, Barnes A, Kent D (2002) Initial experience using the transconjunctival sutureless vitrectomy system for vitreoretinal surgery. Ophthalmology 109:1814–1820. doi:10.1016/S0161-6420(02)01119-3 PubMedCrossRef

Fujii GY, De Juan E Jr, Humayun MS, Pieramici DJ, Chang TS, Awh C, Ng E, Barnes A, Wu SL, Sommerville DN (2002) A new 25-gauge instrument system for transconjunctival sutureless vitrectomy surgery. Ophthalmology 109:1807–1812. doi:10.1016/S0161-6420(02)01179-X PubMedCrossRef

Ibarra MS, Hermel M, Prenner JL, Hassan TS (2005) Longer-term outcomes of transconjunctival sutureless 25-gauge vitrectomy. Am J Ophthalmol 139:831–836. doi:10.1016/j.ajo.2004.12.002 PubMedCrossRef

Lakhanpal RR, Humayun MS, de Juan E Jr, Lim JI, Chong LP, Chang TS, Javaheri M, Fujii GY, Barnes AC, Alexandrou TJ (2005) Outcomes of 140 consecutive cases of 25-gauge transconjunctival surgery for posterior segment disease. Ophthalmology 112:817–824. doi:10.1016/j.ophtha.2004.11.053 PubMedCrossRef

Kwok AK, Tham CC, Lam DS, Li M, Chen JC (1999) Modified sutureless sclerotomies in pars plana vitrectomy. Am J Ophthalmol 127:731–733. doi:10.1016/S0002-9394(98)00427-9 PubMedCrossRef

Milibak T, Suveges I (1998) Complications of sutureless pars plana vitrectomy through self-sealing sclerotomies. Arch Ophthalmol 116:119PubMed

Eckardt C (2005) Transconjunctival sutureless 23-gauge vitrectomy. Retina 25:208–211. doi:10.1097/00006982-200502000-00015 PubMedCrossRef

Chung TY, Chung H, Lee JH (2002) Combined surgery and sequential surgery comprising phacoemulsification, pars plana vitrectomy, and intraocular lens implantation: comparison of clinical outcomes. J Cataract Refract Surg 28:2001–2005. doi:10.1016/S0886-3350(02)01354-8 PubMedCrossRef

Demetriades AM, Gottsch JD, Thomsen R, Azab A, Stark WJ, Campochiaro PA, de Juan E Jr, Haller JA (2003) Combined phacoemulsification, intraocular lens implantation, and vitrectomy for eyes with coexisting cataract and vitreoretinal pathology. Am J Ophthalmol 135:291–296. doi:10.1016/S0002-9394(02)01972-4 PubMedCrossRef

10.

Koenig SB, Mieler WF, Han DP, Abrams GW (1992) Combined phacoemulsification, pars plana vitrectomy, and posterior chamber intraocular lens insertion. Arch Ophthalmol 110:1101–1104PubMed

11.

Azar-Arevalo O, Arevalo JF (2001) Corneal topography changes after vitreoretinal surgery. Ophthalmic Surg Lasers 32:168–172PubMed

12.

Domniz YY, Cahana M, Avni I (2001) Corneal surface changes after pars plana vitrectomy and scleral buckling surgery. J Cataract Refract Surg 27:868–872. doi:10.1016/S0886-3350(00)00755-0 PubMedCrossRef

13.

Slusher MM, Ford JG, Busbee B (2002) Clinically significant corneal astigmatism and pars plana vitrectomy. Ophthalmic Surg Lasers 33:5–8PubMed

14.

Wirbelauer C, Hoerauf H, Roider J, Laqua H (1998) Corneal shape changes after pars plana vitrectomy. Graefes Arch Clin Exp Ophthalmol 236:822–828. doi:10.1007/s004170050166 PubMedCrossRef

15.

Yanyali A, Celik E, Horozoglu F, Nohutcu AF (2005) Corneal topographic changes after transconjunctival (25-gauge) sutureless vitrectomy. Am J Ophthalmol 140:939–941. doi:10.1016/j.ajo.2005.05.042 PubMedCrossRef

16.

Okamoto F, Okamoto C, Sakata N, Hiratsuka K, Yamane N, Hiraoka T, Kaji Y, Oshika T (2007) Changes in corneal topography after 25-gauge transconjunctival sutureless vitrectomy versus after 20-gauge standard vitrectomy. Ophthalmology 114:2138–2141. doi:10.1016/j.ophtha.2007.01.034 PubMedCrossRef

17.

Holladay JT, Cravy TV, Koch DD (1992) Calculating the surgically induced refractive change following ocular surgery. J Cataract Refract Surg 18:429–443PubMed

18.

Kadonosono K, Yamakawa T, Uchio E, Yanagi Y, Tamaki Y, Araie M (2006) Comparison of visual function after epiretinal membrane removal by 20-gauge and 25-gauge vitrectomy. Am J Ophthalmol 142:513–515. doi:10.1016/j.ajo.2006.03.060 PubMedCrossRef

19.

Beltrame G, Salvetat ML, Chizzolini M, Driussi G (2001) Corneal topographic changes induced by different oblique cataract incisions. J Cataract Refract Surg 27:720–727. doi:10.1016/S0886-3350(00)00752-5 PubMedCrossRef

20.

Weinberger D, Lichter H, Loya N, Axer-Siegel R, Muzmacher L, Gabbay U, Yassur Y (1999) Corneal topographic changes after retinal and vitreous surgery. Ophthalmology 106:1521–1524. doi:10.1016/S0161-6420(99)90447-5 PubMedCrossRef

21.

Bergmann MT, Koch DD, Zeiter JH (1988) The effect of scleral cautery on corneal astigmatism in cadaver eyes. Ophthalmic Surg 19:259–262PubMed

22.

Yuen CY, Cheung BT, Tsang CW, Lam RF, Baig NB, Lam DS (2008) Surgically induced astigmatism in phacoemulsification, pars plana vitrectomy, and combined phacoemulsification and vitrectomy: a comparative study. Eye 23:576–580. doi:10.1038/eye.2008.57 PubMedCrossRef

23.

Cravy TV (1989) Long-term corneal astigmatism related to selected elastic, monofilament, nonabsorbable sutures. J Cataract Refract Surg 15:61–69PubMed

24.

Gimbel HV, Raanan MG, DeLuca M (1992) Effect of suture material on postoperative astigmatism. J Cataract Refract Surg 18:42–50PubMed

25.

Arciniegas A, Amaya LE (1984) Experimental modification of the corneal curvature by means of scleral surgery. Ann Ophthalmol 16:1155–1166PubMed

26.

Rowsey JJ (1983) Ten caveats in keratorefractive surgery. Ophthalmology 90:148–155PubMed

27.

Axt JC (1987) Longitudinal study of postoperative astigmatism. J Cataract Refract Surg 13:381–388PubMed

28.

Masket S (1985) Nonkeratometric control of postoperative astigmatism. J Am Intraocul Implant Soc 11:134–137PubMed

Title: Surgically induced astigmatism in combined phacoemulsification and vitrectomy; 23-gauge transconjunctival sutureless vitrectomy versus 20-gauge standard vitrectomy
Authors: Dong Ho Park
Jae Pil Shin
Si Yeol Kim
Publication date: 01-10-2009
Publisher: Springer-Verlag
Published in: Graefe's Archive for Clinical and Experimental Ophthalmology / Issue 10/2009
Print ISSN: 0721-832X
Electronic ISSN: 1435-702X
DOI: https://doi.org/10.1007/s00417-009-1109-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Surgically induced astigmatism in combined phacoemulsification and vitrectomy; 23-gauge transconjunctival sutureless vitrectomy versus 20-gauge standard vitrectomy

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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