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Self-sealing sclerotomies for sutureless pars plana vitrectomy
R Rahman1, P H Rosen, C Riddell
1Department of Ophthalmology, Oxford Eye Hospital, The Radcliffe Infirmary, United Kingdom.
Objective:
To determine the efficacy of self-sealing pars plana sclerotomies for vitrectomy and to identify complications associated with this new technique.
Method:
There were 150 self-sealing sclerotomies performed in 50 patients undergoing pars plana vitrectomy between October 1996 and March 1998.
Results:
Of the 150 sclerotomies, 115 (76.6%) did not require suturing while 35 (23.3%) were closed with one radial 7.0 vicryl suture. The scleral tunnel incisions ensured minimal loss of intraocular fluids during instrument exchange and scleral plugs were not required to avoid ocular hypotony during scleral indentation. Distortion of scleral flap incisions requiring a suture were commonly seen in procedures using multiple instrumentations and extensive explants.
Conclusions:
Sutureless sclerotomies are simple to perform, save operative time, and reduce the risk of peroperative hypotony following removal of instruments or the infusion cannula. The technique reduces postoperative inflammation, suture-related problems including astigmatism, and allows more rapid rehabilitation.