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Risk factors for hypotony after transconjunctival sutureless vitrectomy
Takumi Ando1, Hiroko Terashima1, Kazuma Fujii1
1Department of Ophthalmology, Division of Ophthalmology and Visual Science, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan.
Plos One
|April 28, 2025
Summary
Unexpected hypotony after transconjunctival sutureless vitrectomy (TSV) is linked to longer axial length and no tamponade. Surgeons should consider suturing sclerotomy in high-risk patients to prevent complications.
Area of Science:
- Ophthalmology
- Surgical Innovation
- Retinal Surgery
Background:
- Transconjunctival sutureless vitrectomy (TSV) is a minimally invasive surgical technique.
- Postoperative hypotony, a decrease in intraocular pressure, can lead to complications.
- Identifying risk factors for hypotony is crucial for improving patient outcomes.
Purpose of the Study:
- To determine the risk factors associated with unexpected hypotony following transconjunctival sutureless vitrectomy (TSV).
Main Methods:
- Retrospective observational study analyzing 840 eyes from 748 patients undergoing 25-G or 27-G TSV.
- Postoperative hypotony defined as intraocular pressure (IOP) < 6 mmHg on postoperative day 1.
- Multivariate analysis was performed to identify significant risk factors.
Main Results:
- Hypotony occurred in 16.5% of cases, significantly associated with longer axial length (AL) and absence of intraocular tamponade.
- Patients with longer AL (≥26 mm) and no tamponade had a higher incidence of hypotony.
- Hypotony group experienced more postoperative complications, including choroidal folds and hypotony maculopathy.
Conclusions:
- Longer axial length and lack of tamponade are significant risk factors for hypotony after TSV.
- Consideration of sclerotomy suturing in patients with AL ≥ 26 mm and no tamponade may help prevent hypotony and related complications.
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