Wound morphologies of sclerotomies closed with scleral massage and scleral needling techniques: A comparative study

This prospective study aimed to compare scleral needling with the conventional scleral massage technique for sclerotomy closure, using anterior segment optical coherence tomography (AS-OCT) to assess postoperative wound morphology.

Thirty eyes of 30 patients undergoing pars plana vitrectomy with a 25G vitrectomy system (Constellation; Alcon Laboratories, Fort Worth, TX, USA) were included. In each eye, one superior sclerotomy site (superonasal or superotemporal) was closed with scleral needling (Group A), while the other was closed with scleral massage (Group B), eliminating the impact of individual variability.

Most sclerotomies (80%) could be closed with a single attempt of needling (mean 1.2 ± 0.4). The mean outer and inner sclerotomy incision diameters on the postoperative first day were 119 ± 22 and 94 ± 17 µm, respectively, for group A, and 118 ± 19 and 94 ± 16 µm, respectively, for group B ( P = 0.658 and 0.871, respectively). Sclerotomy wound diameters of both groups A and B decreased significantly on postoperative day 14 ( P < 0.001 and P < 0.001, respectively). None of the patients developed postoperative hypotony or any severe complication. A conjunctival bleb in four Group A patients resolved by day 3.

The newly described scleral needling technique was as successful and safe as the conventional scleral massage technique. AS-OCT imaging also confirmed that scleral needling did not cause any disruption on wound morphology.