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[Self-sealing sclerotomies in pars plana vitrectomy]
J F Korobelnik1, D Hannouche, I Cochereau
1Service d'ophtalmologie, Hôpital Bichat, Paris.
Purpose:
To study a technique of self-sealing sclerotomies, recently described.
Methods:
After conjunctival peritomy, a tunnel incision is performed with a crescent knife, 2 mm posterior to the intended site of entry. Then a 20G microvitreoretinal blade is used to enter the vitreous cavity. From November 1996 to April 1997, 99 primary vitrectomies were prospectively studied.
Results:
292 sclerotomies were performed with this technique. Self-sealing sclerotomies were observed in 270 cases (92.5%). In 22 cases, leakage of fluid required closure with 8-0 nylon sutures. Leakage was related to multiple instruments used through the sclerotomy, or more frequently to a thin scleral wall. In 1 case, transient hypotony was observed. Ocular pressure spontaneously returned to normal.
Conclusions:
Self-sealing sclerotomies are difficult to perform if the sclera is thin, and leakage can be observed if multiple instruments have to be used through the same sclerotomy. But this technique prevents vitreous and retinal herniation through the sclerotomy, and ocular hypotony. It also reduces the operative time, and prevents irritation related to nonabsorbable sutures.