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Experimental and clinical studies of transconjunctival vitrectomy 20G, 23G and 25G
Author(s) -
CHIQUET C
Publication year - 2008
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2008.5213.x
Subject(s) - vitrectomy , medicine , retinal detachment , endophthalmitis , ophthalmology , tamponade , cannula , surgery , retinal tear , retinal , visual acuity
Abstract Purpose Microincision transconjunctival vitrectomy has gained popularity in the recent years. This surgical innovation needs to be evaluated in prospective and controlled studies. Methods A prospective study concerning 23‐Gauge vitrectomy (with cryoapplication and gas tamponade) in 20 patients with retinal detachment and 4 patients with acute endophthalmitis was performed and litterature data (Pubmed database research) was analyzed. Results Performance of microincision transconjunctival vitrectomy may be maximized with use of high duty cycle, largest internal diameter (23G), a sharp guillotine and a high cut rate. Sclerotomy construction is a key point of this technique. In retinal detachment surgery on a selected population, the rate of anatomic reattachment and visual recovery were similar between 23G PPV and 20G PPV. In one patient 23G PPV was complicated by a choroidal detachment secondary to a displacement of the infusion cannula. The redetachment in one 23G case was secondary to a sclerotomy related retinal tear. Microincision transconjunctival vitrectomy for acute endophthalmitis is feasible but has limited capacities as compared with 20G technique. Conclusion The main advantage of sutureless vitrectomy remains the confort of patient after complicated surgeries, but this point should be analyzed with quality of life. This trend toward smaller incisions will lead to improvement of instrumentations, better understanding of the surgical techniques (wound construction, performance of vitreous cutters). 23G PPV is suitable for patients with retinal detachment treated with PPV‐cryo‐gas technique. Sutureless vitrectomy is usefull only in selected cases of acute endophthalmitis .