Corneal topographic changes after transconjunctival 23-gauge sutureless vitrectomy

Area of Science:

• Ophthalmology
• Corneal Surgery
• Vitreo-retinal Surgery

Background:

• Pars plana vitrectomy (PPV) is a common surgical procedure.
• The 23-gauge (23-G) transconjunctival sutureless vitrectomy (TSV) system offers a minimally invasive approach.
• Understanding early postoperative corneal changes is crucial for patient outcomes.

Purpose of the Study:

• To evaluate the topographic changes of the cornea following PPV using the 23-G TSV system.
• To assess alterations in corneal power, astigmatism, and surface regularity within the first postoperative month.

Main Methods:

• Prospective study of 24 eyes undergoing PPV with 23-G TSV.
• Computer-assisted videokeratography (NAVIS) used preoperatively and at 1 day, 1 week, and 1 month postoperatively.
• Analysis of average corneal power (ACP), corneal surface cylinder (CSC), surface asymmetry index (SAI), and surface regularity index (SRI).

Main Results:

• No statistically significant changes were observed in mean ACP, CSC, or SAI at any postoperative time point.
• A significant increase in SRI was noted at the first postoperative day (P=0.001), returning to baseline by the first month (P=0.861).
• Mean surgically induced astigmatism was minimal, with values of 0.67±0.7 D at day 1, 0.36±0.2 D at week 1, and 0.33±0.17 D at month 1.

Conclusions:

• PPV with the 23-G TSV system does not induce significant corneal topographic or astigmatic changes in the early postoperative period.
• The temporary increase in SRI on postoperative day 1 suggests transient corneal surface effects.
• The 23-G TSV system appears to maintain corneal stability post-surgery.