Surgical outcomes of transconjunctival sutureless 23-gauge vitrectomy with silicone oil injection.

ABSTRACT

AIMS: To evaluate the outcomes and complications of 23-gauge transconjunctival sutureless vitrectomy (TSV) with Silicone oil (SO) tamponade in complex vitreoretinal diseases. SETTINGS AND DESIGN: Ege university hospital ophthalmology department. Retrospective case series. MATERIALS AND METHODS: Forty eyes of 40 patients with diabetic tractional retinal detachment (DTRD) and proliferative vitreoretinopathy (PVR) were included in the study. Vitrectomy using 23-gauge system with SO endotamponade was performed. Peroperative and postoperative complications, anatomical and visual results were evaluated. STATISTICAL ANALYSIS USED Paired Student's t-test. RESULTS: Simultaneous cataract surgery was performed in 17 eyes. Peroperative complications were posterior capsule rupture during phacoemulsification in one patient, vitreous and retinal incarceration in one patient. One eye required suture placement at the end of surgery due to SO leakage. Postoperatively, a small subconjunctival SO bubble in three patients, and hypotony in one patient (6 mmHg) were observed. Recurrent retinal detachment under SO occurred in one patient. Mean follow-up was 6.5 months (+/-2.7). Pre- and postoperative mean visual acuity was 2.22+/-0.91 logMAR and 1.11+/-0.8 logMAR, respectively ( P< 0.001). Mean intraocular pressure (IOP) on the first postoperative day was lower than preoperative IOP (11.3 +/-3.2 versus 14.0 +/-2.4 mmHg) ( P< 0.001). CONCLUSIONS: Twenty-three gauge instrumentation seems to be feasible, effective and safe for vitrectomy with SO injection in DTRD and PVR, and can be considered in the surgical management of these complex vitreoretinal diseases.