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Transconjunctival 20-gauge pars plana vitrectomy using a single entry cannulated sutureless system
Judy E Kim1, Sandeep N Shah, Deana L Choi
1The Eye Institute, Department of Ophthalmology, Medical College of Wisconsin, Milwaukee, Wisconsin 53226, USA. judykim@mcw.edu
Retina (Philadelphia, Pa.)
|August 22, 2009
Summary
Suturing was often needed for 20-gauge transconjunctival cannulated sutureless (TCS) vitrectomy sclerotomies due to leakage or gaping. This technique has risks similar to other cannulated systems but may require more sclerotomy suturing than smaller-gauge approaches.
Area of Science:
- Ophthalmology
- Surgical Techniques
- Vitreoretinal Surgery
Background:
- Pars plana vitrectomy utilizes various gauge systems, with smaller gauges offering advantages but potentially higher costs.
- The 20-gauge transconjunctival cannulated sutureless (TCS) system aims to combine benefits of smaller gauges with cost-effectiveness.
- Larger sclerotomy size in the 20-gauge TCS system may challenge self-sealing capabilities.
Purpose of the Study:
- To evaluate the necessity of sclerotomy suturing following 20-gauge TCS vitrectomy.
- To assess complications associated with 20-gauge TCS vitrectomy.
Main Methods:
- Retrospective chart review of 55 eyes from 54 patients undergoing 20-gauge TCS vitrectomy.
- Outcome measures included the rate of sclerotomy suturing and observed complications.
Main Results:
- Out of 164 sclerotomies, 62% were not sutured, while 38% required a single suture.
- Reasons for suturing included leakage, gaping, inadequate conjunctival coverage, and gas leak prevention.
- Complications included cannula dislodging, retinal tears, hypotony, choroidal hemorrhage, and inadequate gas fill.
Conclusions:
- Twenty-gauge TCS vitrectomy presents risks comparable to other cannulated systems.
- This technique preserves functionality and instrumentation of the 20-gauge approach.
- A potential disadvantage is a higher sclerotomy suturing rate compared to smaller-gauge vitrectomy methods.
