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27-GAUGE VITRECTOMY WOUND INTEGRITY: A Randomized Pilot Study Comparing Angled Versus Straight Entry in Fluid-Filled
M Ali Khan1,2, Alia K Durrani1, Jason Hsu1
1Retina Service, Wills Eye Hospital, Mid-Atlantic Retina, Sidney Kimmel Medical College, Philadelphia, Pennsylvania.
Retina (Philadelphia, Pa.)
|March 31, 2017
Summary
Straight trocar insertion during 27-gauge vitrectomy for epiretinal membrane resulted in transiently lower postoperative intraocular pressure (IOP). Wound-related complications were similarly low for both angled and straight incisions.
Area of Science:
- Ophthalmology
- Microsurgery
Background:
- Epiretinal membrane (ERM) surgery requires precise instrumentation.
- Minimally invasive techniques like 27-gauge pars plana vitrectomy are increasingly used.
- Trocar insertion technique may influence surgical outcomes.
Purpose of the Study:
- To compare clinical outcomes of angled versus straight trocar insertion.
- To evaluate intraocular pressure (IOP) and wound-related complications.
- During 27-gauge pars plana vitrectomy for epiretinal membrane.
Main Methods:
- Pilot randomized controlled trial.
- 30 patients undergoing 27-gauge pars plana vitrectomy for ERM.
- Randomized 1:1 to angled or straight trocar insertion.
Main Results:
- No significant difference in phakic status or preoperative IOP.
- Postoperative Day 1: Straight incisions showed lower IOP (P=0.04).
- Low rates of hypotony and sclerotomy complications for both methods.
Conclusions:
- Straight incisions may cause transient early postoperative hypotony.
- Both angled and straight trocar insertion are safe and effective.
- Similar low complication rates support both techniques for ERM surgery.