The Effects of the Scleral Suture in 23-Gauge Transconjunctival Sutureless Vitrectomy

PURPOSE: To evaluate the effects of scleral suture for the sclerotomy wound leakage and the clinical outcomes in 23-gauge transconjunctival sutureless vitrectomy with fluid-air exchange. METHODS: A retrospective, comparative chart review of 75 eyes of 75 patients who underwent 23-gauge transconjunctival vitrecomy with fluid air exchange was performed. The patients were divided into 2 groups according to the scleral suture used at the end of the operation, sclera-sutured group and sutureless group. The amount of intraocular gas remnants was measured to compare the degree of sclerotomy wound leakage and the postoperative intraocular pressure (IOP) and reoperation rate were analyzed. RESULTS: The mean IOP on postoperative day 1, 7 and 14 was 15.5 +/- 4.0 mm Hg in the sclera-sutured group and 15.8 +/- 6.2 mm Hg in the sutureless group, without statistical difference (p = 0.874). The percentage of intraocular gas remnants in eyes on postoperative day 1 was significantly higher in the sclera-sutured group (92.9 +/- 9.7%) than in the sutureless group (82.4 +/- 16.2%; p = 0.002) as well as on postoperative days 7 and 14. The reoperation rate was not statistically significantly different between the sclera-sutured group (6.5%) and sutureless group (9.1%; p = 0.683) CONCLUSIONS: In the cases of 23-gauge sutureless vitrectomy with fluid-air exchange, the scleral suture may be effective to prevent the sclerotomy wound leakage and maintain the intraocular gas longer, but there was no statistically significant difference in the final success rate between the 2 groups. However, as more intraocular gas remained in the sclera-sutured group than in the sutureless group statistically, the scleral suture should be considered in cases that require long-term gas tamponade.

The Impact of Written Information on the Compliance with Contact Lens Care

PURPOSE: To evaluate the impact of written information on the compliance with proper contact lens (CL) care. METHODS: The patients prescribed CLs by a single ophthalmologist in a clinic from January 2008 to August 2009 were enrolled in the present study. The patients were randomly divided into 2 groups, the verbal and written information (VWI) group and verbal information (VI) group. The patients in the VWI group received verbal and written information on proper CL care and the VI group received the same information only verbally. Patients who were followed-up more than 2 weeks after CL wear were asked 10 questions regarding CL care and statistical analysis was performed for each question on CL care. The Mann Whitney U-test was used for comparison between the 2 groups and Pearson's test was used for the correlation analyses. RESULTS: A total of 23 patients were included in this study. Ten patients were assigned to the VWI group, and 13 patients to the VI group. The most desirable score for the CL care was 100 points. The VWI group showed 85.2 +/- 13.4 points and the VI group showed 71.5 +/- 10.1 points (p = 0.030, Mann-Whitney U-test). Of the 10 questions, daily replacement of the lens care solution and the use of tap water showed significant correlation with the discomfort induced by the CL and rinsing process before CL insertion showed significant correlation with the CL intolerance (p = 0.008, p = 0.004 and p = 0.015, respectively, Pearson's correlation test). CONCLUSIONS: The patients in the written information group showed better compliance for overall CL care. Adding the written information to the verbal explanation can enhance the patient's compliance with the proper CL care. Enhancing the compliance of CL care with written information can be expected to decrease the complications and improve the comfort of wearing CLs.