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Graefe's Archive for Clinical and Experimental Ophthalmology

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01-05-2013 | Retinal Disorders

Influence of sutureless 23-gauge sclerotomy architecture on postoperative intraocular pressure decrease: results of a multivariate analysis

Authors: Rachid Tahiri Joutei Hassani, Mohamed El Sanharawi, Raphael Adam, Claire Monin, Sylvère Dupont-Monod, Christophe Baudouin

Published in: Graefe's Archive for Clinical and Experimental Ophthalmology | Issue 5/2013

Abstract

Purpose

To evaluate the factors affecting the postoperative intraocular pressure (IOP) decrease in 23-gauge (23-G) sutureless vitrectomy, including incision architecture evaluated by anterior segment spectral-domain optical coherence tomography (SD-OCT).

Methods

A prospective cohort study of 43 patients who underwent primary transconjunctival 23-G pars plana vitrectomy. All sclerotomy wounds were imaged 1 day after surgery using the anterior segment module of SD-OCT (OCT Spectralis, Heidelberg Engineering, Heidelberg, Germany). 23-G sclerotomy architecture, preoperative and postoperative medical data were also prospectively collected.

Results

Multivariate logistic regression analysis, with backward elimination, found that surgery duration (adjusted OR = 9.17, p = 0.020) and loss of wound apposition (adjusted OR = 15.12, p = 0.022) were risk factors for significant postoperative IOP decrease (≥3 mmHg) 1 day after surgery; while age, gender, myopia, and gas tamponade were not risk or protective factors for postoperative IOP decrease.

Conclusions

In 23-G pars plana vitrectomy, the early postoperative decrease in IOP is mainly influenced by surgery duration and the self-sealing nature of the sclerotomy. The IOP decrease was not influenced by the presence or the absence of gas tamponade.

Chen E (2007) 25-gauge transconjunctival sutureless vitrectomy. Curr Opin Ophthalmol 18(3):188–193PubMedCrossRef

Rizzo S, Genovesi-Ebert F, Murri S, Belting C, Vento A, Cresti F, Manca ML (2006) 25-gauge, sutureless vitrectomy and standard 20-gauge pars plana vitrectomy in idiopathic epiretinal membrane surgery: a comparative pilot study. Graefes Arch Clin Exp Ophthalmol 244(4):472–479PubMedCrossRef

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(12):2138–2141PubMedCrossRef

Lakhanpal RR, Humayun MS, de Juan E, Jr LJI, 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(5):817–824PubMedCrossRef

Romero P, Salvat M, Almena M, Baget M, Méndez I (2006) Experience with 25-gauge transconjunctival vitrectomy compared to a 20-gauge system. Analysis of 132 cases [in French]. J Fr Ophtalmol 29(9):1025–1032PubMedCrossRef

Fine HF, Iranmanesh R, Iturralde D, Spaide RF (2007) Outcomes of 77 consecutive cases of 23-gauge transconjunctival vitrectomy surgery for posterior segment disease. Ophthalmology 114(6):1197–1200PubMedCrossRef

Sandali O, El Sanharawi M, Lecuen N, Barale PO, Bonnel S, Basli E, Borderie V, Laroche L, Monin C (2011) 25-, 23-, and 20-gauge vitrectomy in epiretinal membrane surgery: a comparative study of 553 cases. Graefes Arch Clin Exp Ophthalmol 249(12):1811–1819PubMedCrossRef

Lin AL, Ghate DA, Robertson ZM, O’Sullivan PS, May WL, Chen CJ (2011) Factors affecting wound leakage in 23-gauge sutureless pars plana vitrectomy. Retina 31(6):1101–1108PubMedCrossRef

Woo SJ, Park KH, Hwang JM, Kim JH, Yu YS, Chung H (2009) Risk factors associated with sclerotomy leakage and postoperative hypotony after 23-gauge transconjunctival sutureless vitrectomy. Retina 29(4):456–463PubMedCrossRef

10.

Chen D, Lian Y, Cui L, Lu F, Ke Z, Song Z (2010) Sutureless vitrectomy incision architecture in the immediate postoperative period evaluated in vivo using optical coherence tomography. Ophthalmology 117(10):2003–2009PubMedCrossRef

11.

Shimada H, Nakashizuka H, Mori R, Mizutani Y, Hattori T (2006) 25-gauge scleral tunnel transconjunctival vitrectomy. Am J Ophthalmol 142(5):871–873PubMedCrossRef

12.

López-Guajardo L, Vleming-Pinilla E, Pareja-Esteban J, Teus-Guezala MA (2007) Ultrasound biomicroscopy study of direct and oblique 25-gauge vitrectomy sclerotomies. Am J Ophthalmol 143(5):881–883PubMedCrossRef

13.

Dupont-Monod S, Labbé A, Fayol N, Chassignol A, Bourges JL, Baudouin C (2009) In vivo architectural analysis of clear corneal incisions using anterior segment optical coherence tomography. J Cataract Refract Surg 35(3):444–450PubMedCrossRef

14.

Byeon SH, Lew YJ, Kim M, Kwon OW (2008) Wound leakage and hypotony after 25-gauge sutureless vitrectomy: factors affecting postoperative intraocular pressure. Ophthalmic Surg Lasers Imaging 39(2):94–99PubMedCrossRef

15.

Lommatzsch A, Heimes B, Trieschmann M, Spital G, Pauleikhoff D (2008) Long-term results after pars plana vitrectomy with 25 gauge technique [in German]. Ophthalmologe 105(5):445–451PubMedCrossRef

16.

Valmaggia C (2007) Pars plana vitrectomy with 25-gauge instruments in the treatment of idiopathic epiretinal membranes. Klin Monatsbl Augenheilkd 224(4):292–296PubMedCrossRef

17.

Ho LY, Garretson BR, Ranchod TM, Balasubramaniam M, Ruby AJ, Capone A Jr, Drenser KA, Williams GA, Hassan TS (2011) Study of intraocular pressure after 23-gauge and 25-gauge pars plana vitrectomy randomized to fluid versus air fill. Retina 31(6):1109–1117PubMedCrossRef

18.

Gupta OP, Weichel ED, Regillo CD, Fineman MS, Kaiser RS, Ho AC, McNamara JA, Vander JE (2007) Postoperative complications associated with 25-gauge pars plana vitrectomy. Ophthalmic Surg Lasers Imaging 38(4):270–275PubMed

19.

Yamane S, Kadonosono K, Inoue M, Kobayashi S, Watanabe Y, Arakawa A (2011) Effect of intravitreal gas tamponade for sutureless vitrectomy wounds: three-dimensional corneal and anterior segment optical coherence tomography study. Retina 31(4):702–706PubMed

20.

Eames I, Angunawela RI, Aylward GW, Azarbadegan A (2010) A theoretical model for predicting interfacial relationships of retinal tamponades. Invest Ophthalmol Vis Sci 51(4):2243–2247PubMedCrossRef

Title: Influence of sutureless 23-gauge sclerotomy architecture on postoperative intraocular pressure decrease: results of a multivariate analysis
Authors: Rachid Tahiri Joutei Hassani
Mohamed El Sanharawi
Raphael Adam
Claire Monin
Sylvère Dupont-Monod
Christophe Baudouin
Publication date: 01-05-2013
Publisher: Springer-Verlag
Published in: Graefe's Archive for Clinical and Experimental Ophthalmology / Issue 5/2013
Print ISSN: 0721-832X
Electronic ISSN: 1435-702X
DOI: https://doi.org/10.1007/s00417-012-2183-5

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Springer Medicine

Influence of sutureless 23-gauge sclerotomy architecture on postoperative intraocular pressure decrease: results of a multivariate analysis

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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